MEDICARE: MR. FRANK PIERREPONT WHITRIDGE JR. BA, LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MA9129	FL

General Provider Information

NPI Number	:	1023026218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FRANK PIERREPONT WHITRIDGE JR. BA, LMT

Provider Business Mailing Address
First Line	:	1232 BONEFISH CT
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34949-2901
Country	:	US
Telephone Number	:	772-332-6116
Fax Number	:	772-460-0581

Provider Business Practice Location Address
First Line	:	1232 BONEFISH CT
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34949-2901
Country	:	US
Telephone Number	:	772-332-6116
Fax Number	:	772-460-0581

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	07/08/2007

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Directions to “ MR. FRANK PIERREPONT WHITRIDGE JR. BA, LMT” Practice Location

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