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General NPI Number Information
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NPI Number | 1518209824
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Entity Type | Individual
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Provider Name | CHERYL LYNN PUTNAM LMT
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Gender | Female
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Dates
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Enumeration Date | 03/25/2013
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Last Update Date | 03/25/2013
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Provider Practice Location Address
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Address Line | 4168 WOODLANDS PKWY SUITE B
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City | PALM HARBOR
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State | FL
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Zip | 34685-3496
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Country | US
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Telephone | 727-785-2545
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Fax | 727-781-0617
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Provider Business Mailing Address
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Address Line | 1715 MARINER WAY
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-5852
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Country | US
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Telephone | 727-940-3697
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | MA66050
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License Number State | FL
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