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General NPI Number Information
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NPI Number | 1952142309
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Entity Type | Organization
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Legal Business Name | AT PEACE MASSAGE & BODYWORK
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Dates
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Enumeration Date | 05/31/2024
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Last Update Date | 05/31/2024
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Provider Practice Location Address
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Address Line | 1964 HOWELL BRANCH RD STE 101
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City | WINTER PARK
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State | FL
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Zip | 32792-1042
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Country | US
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Telephone | 407-718-9036
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Fax |
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Provider Business Mailing Address
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Address Line | 287 SANDLEWOOD TRL # 4
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City | WINTER PARK
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State | FL
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Zip | 32789-1150
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Country | US
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Telephone | 407-718-9036
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Fax |
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Authorized Official
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Title or Position | OWNER/ PRACTITIONER
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Name | TESS FALK
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Credential | LMT, MMT
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Telephone | 407-718-9036
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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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