Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA0023578 | FL |
NPI | 1023029634 |
---|---|
Provider Name | Ms. Evelyn Voigt |
First Address | Brandon, FL 33511-6115 |
Second Address | Brandon, FL 33511-6115 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 08/07/2007 |