Individual
ALLEN TIMOTHY STANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, CMMP
Contact information
Practice address
510 CO. ROAD 466, SUITE 207 J, LADY LAKE, FL 32159-3215
(352) 561-2991
Mailing address
168 SILVER MAPLE RD, GROVELAND, FL 34736-3654
(757) 947-4035
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA85566
FL
Other
Enumeration date
08/28/2020
Last updated
08/28/2020
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