Individual provider · NPI-1

Lois Black, RN LMT

Massage Therapist · Clearwater, FL

NPI number1326497892
StatusActive
Last updated in NPPESJul 26, 2016

Details

NPI
1326497892
Entity type
Individual (NPI-1)
Name
Lois Black
Credential
RN LMT
Sex
Female
Sole proprietor
Yes
Enumeration date
Jun 6, 2016
Last updated
Jul 26, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225700000X Massage Therapist80629FLYes
163WM1400X Registered Nurse, Nurse Massage Therapist (NMT)9420096FL

Practice location

111 N Belcher Rd
Suite 203b
Clearwater, FL 33765-3257

Phone 727-304-3790

Mailing address

642 Belted Kingfisher Dr N
Palm Harbor, FL 34683-6257

Phone 978-505-3791

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