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Individual

MS. JOANNE RUTH BELLOW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMBT

Contact information

Practice address
17521 US HIGHWAY 441, MOUNT DORA, FL 32757-6737
(352) 638-0391
Mailing address
13024 YALE BLUFF DR, GRAND ISLAND, FL 32735-8956
(352) 638-0391

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
MA47425
FL
225700000X
Massage Therapist
Primary
MA47425
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30030608921
FL
05
300608921
FL
05
692420496
FL
Enumeration date
01/22/2008
Last updated
10/19/2018
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