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Organization
PAIN SOLUTIONS THERAPEUTIC & SPORTS MASSAGE
Active
Organization
PAIN SOLUTIONS THERAPEUTIC & SPORTS MASSAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA FAYE NYBERG LMT (SOLE PROPRIETER/ MASSAGE THERAPIST)
(352) 226-2976
Entity
Organization
Contact information
Practice address
25355 W NEWBERRY RD, SUITE 2, NEWBERRY, FL 32669-4253
(352) 226-2976
Mailing address
PO BOX 983, NEWBERRY, FL 32669-0983
(352) 226-2976
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA46707
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912125931
INDIVIDUAL NPI
FL
Enumeration date
04/23/2012
Last updated
04/23/2012
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