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Organization
RESTORE MASSAGE THERAPY LLC
Active
Organization
RESTORE MASSAGE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHANNA A BEATY (OWNER)
(239) 265-4727
Entity
Organization
Contact information
Practice address
1222 SE 47TH ST STE 110, CAPE CORAL, FL 33904-9602
(239) 265-4727
Mailing address
1222 SE 47TH ST STE 110, CAPE CORAL, FL 33904-9602
(239) 265-4727
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MM36953
MASSAGE ESTABLISHMENT
FL
Enumeration date
01/29/2020
Last updated
03/06/2020
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