Individual
LISA ANN WHITESELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA72926
Contact information
Practice address
5307 MAIN ST, NEW PORT RICHEY, FL 34652-2536
(727) 900-7788
Mailing address
10808 DEERBERRY DR, LAND O LAKES, FL 34638-6894
(727) 247-7153
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA72926
FL
Other
Enumeration date
06/10/2019
Last updated
06/10/2019
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