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PAULA BLACK LMT

>> Massage Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1386829455

Individual Registrant:
 PAULA  BLACK LMT
Gender: F
Sole Proprietor

Location and contact information for practice:
2430 S BAY ST  EUSTIS, FL 32726-6363 US
Tel: 352-217-5913  Fax: 800-878-6689

Contact information for business:
37110 SHALIMAR DR  FRUITLAND PARK, FL 34731-5693 US
Tel: 352-217-5913  Fax: 800-878-6689

Registration Information:
NPI: 1386829455
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225700000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Massage Therapist
FLMA41889

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
BCBSC2910FL01




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