Organization
CLEARWATER BEACH SPA, INC.
Active
Organization
CLEARWATER BEACH SPA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLAUDE GIBSON HOOTEN III LMT (PRESIDENT)
(727) 460-4789
Entity
Organization
Contact information
Practice address
641 1/2 MANDALAY AVE, CLEARWATER, FL 33767-1523
(727) 461-7041
Mailing address
1154 GRANADA ST, CLEARWATER, FL 33755-1036
(727) 461-7041
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
16689
FL
Other
Enumeration date
11/21/2014
Last updated
11/21/2014
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