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General NPI Number Information
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NPI Number | 1760528129
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Entity Type | Individual
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Provider Name | PATRICIA WELLER L.M.T.
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Gender | Female
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 784 US HIGHWAY 1 SUITE 3
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City | NORTH PALM BEACH
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State | FL
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Zip | 33408-4415
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Country | US
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Telephone | 561-625-3040
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Fax | 954-963-7169
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Provider Business Mailing Address
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Address Line | 784 US HIGHWAY 1 SUITE 3
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City | NORTH PALM BEACH
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State | FL
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Zip | 33408-4415
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Country | US
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Telephone | 561-625-3040
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Fax | 954-963-7169
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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 | MA20136
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License Number State |
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