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General NPI Number Information
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NPI Number | 1841685930
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Entity Type | Individual
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Provider Name | CHRISTIE TINA RENEE RASK LMT
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Gender | Female
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Dates
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Enumeration Date | 04/06/2015
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Last Update Date | 01/05/2016
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Provider Practice Location Address
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Address Line | 7350 FUTURES DR STE 22 STE. 19
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City | ORLANDO
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State | FL
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Zip | 32819-9084
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Country | US
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Telephone | 407-301-7502
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Fax |
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Provider Business Mailing Address
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Address Line | 3053 DASHA PALM DR
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City | KISSIMMEE
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State | FL
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Zip | 34744-9180
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Country | US
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Telephone | 407-301-7502
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Fax |
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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 | MA72485
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License Number State | FL
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