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MR. T. REX DARR LMT

>> Specialist >> Other Service Providers

Registrant NPI Number: 1598818809

Individual Registrant:
MR. T. REX  DARR LMT
Gender: M
Sole Proprietor

Location and contact information for practice:
14862 MAIN ST  ALACHUA, FL 32615-8590 US
Tel: 386-462-0032  Fax: 386-462-0032

Contact information for business:
14712 NW 145TH TER  ALACHUA, FL 32615-8630 US
Tel: 386-462-0032  Fax: 386-462-0032

Registration Information:
NPI: 1598818809
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y174400000XOther Service Providers
Specialist
FLMA24667

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
PROVIDER NUMBERC8003FL01
MASSAGE LICENSE NUMBERMA24667FL01




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