Organization
INDIGO EARTH SPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA SMITH L.M.T., F.S. (OWNER/MEDICAL MASSAGE PRACTITIONER)
(850) 303-3669
Entity
Organization
Contact information
Practice address
443 GRACE AVE, PANAMA CITY, FL 32401-2721
(850) 303-3669
(850) 252-6030
Mailing address
443 GRACE AVE, PANAMA CITY, FL 32401-2721
(850) 303-3669
(850) 252-6030
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
MA63341
FL
Other
Enumeration date
09/21/2015
Last updated
09/21/2015
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