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General NPI Number Information
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NPI Number | 1689933525
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Entity Type | Organization
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Legal Business Name | KNEAD2RELAX MASSAGE THERAPY, INC
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Dates
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Enumeration Date | 05/13/2012
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Last Update Date | 05/13/2012
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Provider Practice Location Address
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Address Line | 229 BELLAGIO CIR
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City | SANFORD
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State | FL
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Zip | 32771-5001
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Country | US
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Telephone | 407-952-3863
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Fax |
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Provider Business Mailing Address
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Address Line | 229 BELLAGIO CIR
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City | SANFORD
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State | FL
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Zip | 32771-5001
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Country | US
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Telephone | 407-952-3863
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Fax |
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Authorized Official
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Title or Position | LICENSED MASSAGE THERAPIST/ OWNER
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Name | MRS. STEPHANIE R PIERCE
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Credential | LMT
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Telephone | 407-952-3863
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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 | MM23617
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License Number State | FL
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