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Organization
LYMPHATIC WELLNESS CENTER, LLC
Active
Organization
LYMPHATIC WELLNESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAUN TAYLOR SMITH (OWNER/OPERATOR)
(904) 797-8787
Entity
Organization
Contact information
Practice address
2460 OLD MOULTRIE RD, SUITE 4, ST AUGUSTINE, FL 32086-4197
(904) 797-8787
(904) 797-8728
Mailing address
2460 OLD MOULTRIE RD, SUITE 4, ST AUGUSTINE, FL 32086-4197
(904) 797-8787
(904) 797-8728
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
06/13/2006
Last updated
08/23/2007
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