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Organization
NEURO MASSAGE THERAPIST, INC.
Active
Organization
NEURO MASSAGE THERAPIST, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN SABELLA (CREDENTIALING DEPT)
(561) 241-1971
Entity
Organization
Contact information
Practice address
8595 COLLEGE PKWY, UNIT A2, FORT MYERS, FL 33919-5191
(239) 489-2290
(239) 482-6028
Mailing address
2295 NW CORPORATE BLVD, SUITE 140, BOCA RATON, FL 33431-7373
(561) 241-1971
(561) 241-3969
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MM16119
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MM16119
LICENSE NUMBER
FL
Enumeration date
04/11/2007
Last updated
08/22/2020
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