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Individual

MS. LORI BODEN GAINES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.M.T.

Contact information

Practice address
2800 BAHIA VISTA ST STE 400, SARASOTA, FL 34239-2710
(941) 587-5030
Mailing address
5603 NEW YORK AVE, SARASOTA, FL 34231-8420
(941) 587-5030

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA35911
FL

Other

Enumeration date
01/09/2013
Last updated
01/09/2013
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