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General NPI Number Information
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NPI Number | 1992006860
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Entity Type | Organization
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Legal Business Name | OCEAN TOUCH MASSAGE, LLC
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Dates
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Enumeration Date | 11/09/2010
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Last Update Date | 11/09/2010
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Provider Practice Location Address
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Address Line | 111 CUYAHOGA RD
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City | LAKE WORTH
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State | FL
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Zip | 33467-3819
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Country | US
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Telephone | 954-647-3707
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Fax |
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Provider Business Mailing Address
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Address Line | 111 CUYAHOGA RD
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City | LAKE WORTH
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State | FL
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Zip | 33467-3819
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Country | US
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Telephone | 954-647-3707
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Fax |
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Authorized Official
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Title or Position | MASSAGE THERAPIST/OWNER
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Name | MELINDA R BUONO-MORGAN
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Credential | LMT
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Telephone | 954-647-3707
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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 | MA60253
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License Number State | FL
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