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General NPI Number Information
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NPI Number | 1811755663
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Entity Type | Organization
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Legal Business Name | AMANDA BOONE DBA TRUE MASSAGE
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Dates
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Enumeration Date | 03/07/2024
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Last Update Date | 03/07/2024
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Provider Practice Location Address
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Address Line | 1813 JOHN SIMS PKWY E
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City | NICEVILLE
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State | FL
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Zip | 32578-2337
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Country | US
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Telephone | 850-792-4792
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Fax | 888-315-8783
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Provider Business Mailing Address
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Address Line | 1813 JOHN SIMS PKWY E
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City | NICEVILLE
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State | FL
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Zip | 32578-2337
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Country | US
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Telephone | 850-792-4792
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Fax | 888-315-8783
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Authorized Official
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Title or Position | OWNER, LICENSED MASSAGE THERAPIST
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Name | AMANDA BOONE
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Credential | LMT MA55291
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Telephone | 850-792-4792
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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 |
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License Number State |
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