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General NPI Number Information
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NPI Number | 1841209897
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Entity Type | Individual
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Provider Name | DAISY CLANTON MILLETT LMT, LMBT
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Gender | Female
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 03/31/2017
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Provider Practice Location Address
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Address Line | 527 UMATILLA BLVD
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City | UMATILLA
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State | FL
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Zip | 32784-9091
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Country | US
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Telephone | 352-669-8978
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Fax | 352-669-8978
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Provider Business Mailing Address
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Address Line | PO BOX 411
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City | PAISLEY
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State | FL
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Zip | 32767-0411
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Country | US
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Telephone | 352-669-8978
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Fax | 352-669-8978
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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 | 239
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA25673
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License Number State | FL
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