Organization
JOHN R. ELLIS MASSAGE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN R. ELLIS LMT (OWNER/PRESIDENT)
(239) 872-4641
Entity
Organization
Contact information
Practice address
12621 NEW BRITTANY BLVD, SUITE 17W, FORT MYERS, FL 33907-3631
(239) 872-4641
Mailing address
1801 BRANTLEY RD, #801, FORT MYERS, FL 33907-3994
(239) 872-4641
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA40808
FL
Other
Enumeration date
10/23/2008
Last updated
10/23/2008
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