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General NPI Number Information
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NPI Number | 1932437159
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Entity Type | Organization
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Legal Business Name | P.A.M. FITNESS PLUS, INC.
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Dates
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Enumeration Date | 11/29/2009
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Last Update Date | 11/29/2009
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Provider Practice Location Address
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Address Line | 9511 BOCA GARDENS CIR S STE. C
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City | BOCA RATON
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State | FL
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Zip | 33496-3757
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Country | US
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Telephone | 561-306-5260
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Fax |
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Provider Business Mailing Address
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Address Line | 9511 BOCA GARDENS CIR S STE. C
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City | BOCA RATON
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State | FL
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Zip | 33496-3757
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Country | US
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Telephone | 561-306-5260
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PATRICIA BECKER
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Credential | LMT
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Telephone | 561-306-5260
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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 | 17713
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License Number State | FL
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