Organization
BAYHAVEN
Active
Other names
Bayhaven Massage
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DONNA HALL LMT, NMT (OWNER/THERAPIST)
(727) 822-8808
Entity
Organization
Contact information
Practice address
1201 4TH ST S, ST PETERSBURG, FL 33701-5223
(727) 822-8808
Mailing address
PO BOX 35189, ST PETERSBURG, FL 33705-0504
(727) 822-8808
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
MA 44842
FL
332900000X
Non-Pharmacy Dispensing Site
Primary
MM19938
FL
Other
Enumeration date
12/12/2008
Last updated
12/12/2008
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