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Organization

LAKEWOOD RANCH MEDICAL MASSAGE, LLC

Active
Other names
Mad Science Massage
Organization subpart
No

Provider details

NPI number
Authorized official
ELIZABETH NICOLE PUGH LMT (OWNER / THERAPIST)
(941) 321-5311
Entity
Organization

Contact information

Practice address
9070 58TH DR E STE 102, BRADENTON, FL 34202-6110
(941) 321-5311
(941) 321-5311
Mailing address
11161 E STATE ROAD 70 STE 110-360, LAKEWOOD RANCH, FL 34202-9407
(941) 321-5311

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA40424
FL

Other

Enumeration date
06/18/2017
Last updated
06/18/2017
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