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General NPI Number Information
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NPI Number | 1780097030
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Entity Type | Organization
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Legal Business Name | TRIO FLOW WELLNESS, INC
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Dates
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Enumeration Date | 06/04/2014
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Last Update Date | 06/04/2014
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Provider Practice Location Address
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Address Line | 14500 TAMIAMI TRL E LOT 106
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City | NAPLES
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State | FL
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Zip | 34114-8428
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Country | US
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Telephone | 239-207-0022
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Fax |
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Provider Business Mailing Address
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Address Line | 3811 AIRPORT RD N SUITE 205A
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City | NAPLES
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State | FL
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Zip | 34105-2512
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Country | US
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Telephone | 239-207-0022
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Fax |
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Authorized Official
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Title or Position | PRES/OWNER
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Name | MS. MARY LIZABETH WHITLEY
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Credential | LMT, MMP
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Telephone | 239-207-0022
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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 | MA 46629
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License Number State | FL
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