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BACK TO EDEN

Active
Other names
Back to Eden Wellness Center
Organization subpart
No

Provider details

NPI number
Authorized official
LYNNETTE R BLAKE CNHP,ND (OWNER)
(772) 600-5815
Entity
Organization

Contact information

Practice address
209 SW FEDERAL HWY, STUART, FL 34994-2003
(772) 600-5815
(772) 600-8012
Mailing address
209 SW FEDERAL HWY, STUART, FL 34994-1005
(772) 600-5815
(772) 600-8012

Taxonomy

Speciality
Code
Description
License number
State
175F00000X
Naturopath
225700000X
Massage Therapist
Primary
MM27262
FL

Other

Enumeration date
10/27/2010
Last updated
03/27/2012
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