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Individual

LEANN C ELMORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
8840 44TH AVE, SEBASTIAN, FL 32958-7556
(772) 882-9773
Mailing address
PO BOX 650124, VERO BEACH, FL 32965-0124
(772) 882-9773

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA41181
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C3752
BLUE CROSS & BLUE SHIELD
FL
Enumeration date
07/11/2007
Last updated
09/29/2008
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