Individual
MS. LISA MICHELE COOLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
1804 W BAKER ST, SUITE F, PLANT CITY, FL 33563-2900
(813) 719-1963
Mailing address
1807 KIM ACRES LN, DOVER, FL 33527-6011
(813) 657-2233
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA43897
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA43897
STATE OF FLORIDA LICENSE NUMBER
FL
Enumeration date
12/04/2008
Last updated
03/03/2011
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