MEDICARE: MRS. ELIZABETH ANN GUISER L.M.T.

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	174400000X	Specialist	MA23840	FL

General Provider Information

NPI Number	:	1134185812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH ANN GUISER L.M.T.

Provider Business Mailing Address
First Line	:	1971 FOREST AVE
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32119-5505
Country	:	US
Telephone Number	:	386-761-1193
Fax Number	:

Provider Business Practice Location Address
First Line	:	1971 FOREST AVE
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32119-5505
Country	:	US
Telephone Number	:	386-761-1193
Fax Number	:

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

Provider Enumeration Date	:	04/22/2006
Last Update Date	:	07/09/2007

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