Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA12121 | FL |
NPI | 1013197672 |
---|---|
Provider Name | Mr. Peter Robbins |
First Address | Margate, FL 33063-5675 |
Second Address | Margate, FL 33063-5675 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2007 |
Last Update Date | 11/11/2007 |