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General NPI Number Information
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NPI Number | 1760980528
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Entity Type | Individual
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Provider Name | ELIZABETH JOANNE WINLAND MS, LAT, ATC, LMT
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Gender | Female
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Dates
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Enumeration Date | 01/26/2018
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Last Update Date | 01/26/2018
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Provider Practice Location Address
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Address Line | 14104 ESPERANZA DR
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City | HASLET
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State | TX
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Zip | 76052-4870
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Country | US
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Telephone | 817-729-1454
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Fax |
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Provider Business Mailing Address
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Address Line | 14104 ESPERANZA DR
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City | HASLET
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State | TX
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Zip | 76052-4870
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Country | US
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Telephone | 817-729-1454
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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 | MT122141
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT5390
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License Number State | TX
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