Individual
LISA NICOLE TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
601 GRAND PANAMA BLVD, PANAMA CITY BEACH, FL 32407-3456
(850) 276-3719
Mailing address
750 CASON CIR, PANAMA CITY, FL 32405-6471
(706) 255-2087
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA76620
FL
Other
Enumeration date
10/13/2023
Last updated
10/13/2023
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