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Organization

INTEGRATIVE BODYWORK

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JIM FAZIO L.M.T (MASSAGE THERAPIST)
(321) 456-5051
Entity
Organization

Contact information

Practice address
211 MCLEOD ST, MERRITT ISLAND, FL 32953-3463
(321) 456-5051
Mailing address
211 MCLEOD ST, MERRITT ISLAND, FL 32953-3463
(321) 456-5051

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA20719
FL

Other

Enumeration date
02/04/2008
Last updated
02/04/2008
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