MEDICARE: CELIA H HANDWOHL 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	MA55710	FL

General Provider Information

NPI Number	:	1205062569
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CELIA H HANDWOHL LMT

Provider Business Mailing Address
First Line	:	2346 CANEY WOOD CT
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32218-9092
Country	:	US
Telephone Number	:	754-423-5330
Fax Number	:

Provider Business Practice Location Address
First Line	:	2346 CANEY WOOD CT
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32218-9092
Country	:	US
Telephone Number	:	754-423-5330
Fax Number	:

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

Provider Enumeration Date	:	06/01/2009
Last Update Date	:	08/11/2021

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