Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA59005 | FL |
NPI | 1013223155 |
---|---|
Provider Name | Sharon Munroe |
First Address | Homosassa, FL 34448-3112 |
Second Address | Homosassa, FL 34446-2601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2010 |
Last Update Date | 26/08/2010 |