Individual
JOHANNA A BEATY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1222 SE 47TH ST STE 110, CAPE CORAL, FL 33904-9602
(239) 265-4727
Mailing address
1222 SE 47TH ST STE 110, CAPE CORAL, FL 33904-9602
(239) 265-4727
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA47405
FL
Other
Enumeration date
01/22/2020
Last updated
01/22/2020
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