Individual
LISHA MYRANDA ESTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1829 EDWARDS RD, SOUTHPORT, FL 32409-2403
(850) 867-3304
Mailing address
10720 HUTCHISON BLVD STE B, PANAMA CITY BEACH, FL 32407-3708
(850) 249-3988
(850) 215-8398
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA90239
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA90239
STATE LICENSE
FL
Enumeration date
07/17/2019
Last updated
07/17/2019
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