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Individual

DEETA WIDMER ADKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
A.P., L.M.T

Contact information

Practice address
2411 NW 41ST ST, SUITE D, GAINESVILLE, FL 32606-7499
(352) 375-0235
(352) 335-3939
Mailing address
1771 SW 35TH AVE, GAINESVILLE, FL 32608-3427
(352) 375-6626
(352) 335-3939

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AP665
FL
225700000X
Massage Therapist
MA8292
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AP665
ACUPUNCTURE LICENSE
FL
01
C0243
ACUPUNCTURE PROVIDER BCBS
FL
01
C5562
MASSAGE PROVIDER BCBS
FL
01
MA8292
MASSAGE STATE LICENSE
FL
Enumeration date
04/10/2007
Last updated
12/03/2015
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