Individual
LISA J SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1915 NE 45TH ST, SUITE 104B, FT LAUDERDALE, FL 33308-5199
(954) 415-6285
(954) 782-6564
Mailing address
1900 NE 28TH AVE, POMPANO BEACH, FL 33062-3119
(954) 415-6285
(954) 782-6564
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA56206
FL
225700000X
Massage Therapist
MM27808
FL
Other
Enumeration date
12/16/2011
Last updated
12/16/2011
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