Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225700000X | Massage Therapist | MA 57855 | FL |
NPI | 1013239961 |
---|---|
Provider Name | Carola H Cooper |
First Address | Gainesville, FL 32606-4949 |
Second Address | Gainesville, FL 32606-4949 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2010 |
Last Update Date | 25/10/2018 |