Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA32950 | FL |
NPI | 1013923168 |
---|---|
Provider Name | Linda C Walker |
First Address | Auburndale, FL 33823-3435 |
Second Address | Auburndale, FL 33823-3435 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 26/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MA 32950 | MASSAGE THERAPIST (01) | FL |