Individual
MRS. CHRISTINE E. SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2425 N COURTENAY PKWY, SUITE #8, MERRITT ISLAND, FL 32953-4100
(321) 454-2070
Mailing address
2425 N COURTENAY PKWY, SUITE #8, MERRITT ISLAND, FL 32953-4100
(321) 454-2070
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA31088
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA31088
PROFESSIONAL LICENSE
FL
01
—
MM14554
ESTABLISHMENT LICENSE
FL
Enumeration date
06/11/2007
Last updated
07/08/2007
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