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General NPI Number Information
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NPI Number | 1922495241
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Entity Type | Organization
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Legal Business Name | DEBRA MACE
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Dates
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Enumeration Date | 04/24/2015
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Last Update Date | 04/24/2015
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Provider Practice Location Address
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Address Line | 509 US 1
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City | WEST PALM BEACH
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State | FL
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Zip | 33403-3573
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Country | US
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Telephone | 561-465-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 15357 76TH TRL N
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City | WEST PALM BEACH
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State | FL
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Zip | 33418-7316
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Country | US
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Telephone | 561-351-6225
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Fax |
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Authorized Official
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Title or Position | MASSAGE THERAPIST
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Name | DEBRA M MACE
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Credential | L.M.T.
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Telephone | 561-351-6225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | MA40066
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License Number State | FL
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