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General NPI Number Information
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NPI Number | 1487894689
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Entity Type | Organization
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Legal Business Name | WESTHOM WELLNESS
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Dates
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Enumeration Date | 02/27/2009
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Last Update Date | 03/23/2010
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Provider Practice Location Address
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Address Line | 10345 STATE ROAD 52
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City | HUDSON
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State | FL
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Zip | 34669-3097
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Country | US
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Telephone | 727-857-1122
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Fax | 727-379-0658
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Provider Business Mailing Address
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Address Line | 10345 STATE ROAD 52
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City | HUDSON
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State | FL
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Zip | 34669-3097
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Country | US
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Telephone | 727-857-1122
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Fax | 727-379-0658
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Authorized Official
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Title or Position | SENIOR THERAPIST
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Name | MS. JOYCE R. WEST
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Credential | LMT
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Telephone | 727-857-1122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MM21487
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License Number State | FL
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