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General NPI Number Information
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NPI Number | 1811268022
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Entity Type | Organization
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Legal Business Name | BLISSFUL HEALINGS MASSAGE, LLC
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Dates
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Enumeration Date | 01/19/2012
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Last Update Date | 01/19/2012
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Provider Practice Location Address
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Address Line | 4817 NE 2ND LOOP
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City | OCALA
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State | FL
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Zip | 34470-1524
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Country | US
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Telephone | 352-624-2337
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Fax |
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Provider Business Mailing Address
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Address Line | 3791 SE 66TH PL
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City | OCALA
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State | FL
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Zip | 34480-8956
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Country | US
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Telephone |
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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. WENDY FISK
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Credential | L.M.T.
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Telephone | 352-216-2486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA50595
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License Number State | FL
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