Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA27218 | FL |
NPI | 1013101435 |
---|---|
Provider Name | Ms. Violet R Kaminski |
First Address | Fort Lauderdale, FL 33314 |
Second Address | Juno Beach, FL 33408 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2007 |
Last Update Date | 29/08/2007 |