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General NPI Number Information
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NPI Number | 1780040030
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Entity Type | Organization
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Legal Business Name | REAM ENTERPRISES LLC
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Dates
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Enumeration Date | 01/01/2016
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Last Update Date | 01/01/2016
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Provider Practice Location Address
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Address Line | 401 W 14TH ST SUITE 5
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City | LYNN HAVEN
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State | FL
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Zip | 32444-3789
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Country | US
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Telephone | 850-866-4456
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Fax |
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Provider Business Mailing Address
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Address Line | 1102 COLORADO AVE
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City | LYNN HAVEN
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State | FL
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Zip | 32444-2820
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Country | US
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Telephone | 850-207-0694
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Fax |
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Authorized Official
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Title or Position | LICENSED MASSAGE THERAPIST
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Name | MRS. CANDACE DANIELLE REAM
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Credential |
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Telephone | 850-207-0694
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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 | MA70788
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License Number State | FL
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