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NPI Code Detail

MEDICARE: VICKI LYNN BOOHER

MEDICARE:   VICKI LYNN BOOHER
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
1225700000XMassage TherapistMA7164FL

General Provider Information

NPI Number : 1871898155
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICKI LYNN BOOHER
Provider Business Mailing Address
First Line : 750 N THORNTON AVE
Second Line :
City : ORLANDO
State : FL
Zip : 32803-4032
Country : US
Telephone Number : 407-894-8405
Fax Number :
Provider Business Practice Location Address
First Line : 750 N THORNTON AVE
Second Line :
City : ORLANDO
State : FL
Zip : 32803-4032
Country : US
Telephone Number : 407-894-8405
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2011
Last Update Date : 01/19/2011

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Directions to “ VICKI LYNN BOOHER ” Practice Location

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