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Organization
RECONCILED THERAPY
Active
Organization
RECONCILED THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLETTE VICTORIA MORALES LMT (LICENSED MASSAGE THERAPIST)
(561) 846-0275
Entity
Organization
Contact information
Practice address
742 VENICE CIR, APT 104, LAKE PARK, FL 33403-1872
(561) 846-0275
Mailing address
742 VENICE CIR, APT 104, LAKE PARK, FL 33403-1872
(561) 846-0275
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA56364
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225700000X
MEDICAL MASSAGE LICENSED MASSAGE THERAPIST HEALTH/PIP INSURANCE
FL
Enumeration date
06/20/2011
Last updated
06/20/2011
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