Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA28712 | FL |
NPI | 1013111038 |
---|---|
Provider Name | Dawn Clifton |
First Address | Boynton Beach, FL 33426-6332 |
Second Address | Boynton Beach, FL 33426-6332 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 08/07/2007 |