Organization
NOUVELLE VIE THERAPY, CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANNETH CLAVIJO MASSAGE THERAPIST (PRESIDENT)
(786) 227-2494
Entity
Organization
Contact information
Practice address
916 NW 167TH AVE, PEMBROKE PINES, FL 33028-1478
(217) 371-6369
Mailing address
916 NW 167TH AVE, PEMBROKE PINES, FL 33028-1478
(217) 371-6369
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
MA235512
FL
305S00000X
Point of Service
Primary
MA235512
FL
Other
Enumeration date
02/22/2015
Last updated
02/22/2015
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