MEDICARE: HOLLY MARIE DAVIS 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	MA106696	FL

General Provider Information

NPI Number	:	1225837784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY MARIE DAVIS LMT

Provider Business Mailing Address
First Line	:	PO BOX 310
Second Line	:
City	:	CANTONMENT
State	:	FL
Zip	:	32533-0310
Country	:	US
Telephone Number	:	850-207-2716
Fax Number	:

Provider Business Practice Location Address
First Line	:	3076 GULF BREEZE PKWY STE 4
Second Line	:
City	:	GULF BREEZE
State	:	FL
Zip	:	32563-3246
Country	:	US
Telephone Number	:	850-207-2716
Fax Number	:

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

Provider Enumeration Date	:	03/10/2025
Last Update Date	:	03/29/2025

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Directions to “ HOLLY MARIE DAVIS LMT” Practice Location

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