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Individual

DEBORAH BRUGH WEMPLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.M.T.

Contact information

Practice address
120 FAULKNER ST, NEW SMYRNA BEACH, FL 32168-7018
(386) 428-0723
(386) 428-0723
Mailing address
PO BOX 645, NEW SMYRNA BEACH, FL 32170-0645
(386) 428-0723
(386) 428-0723

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA7990
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
689214196
FL
01
C5173
BLUECROSS BLUESHIELD
FL
Enumeration date
04/02/2007
Last updated
11/11/2010
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