Ladon Stacy Lewis L.M.T.

NPI 1104084300 - Massage Therapist - 225700000X

NPI Details
NPI 1104084300
Gender Male
Enumeration Date 05/26/2008
Last Updated 05/26/2008
Entity Type Individual
Active Over 9 years ago
Practice Location
APT. 101
PORT ORANGE FL, 32129-5336, US
Phone (386) 679-4996
Fax (386) 322-3870
Business Location
PO BOX 422
DAYTONA BEACH FL, 32115-0422, US
Phone (386) 679-4996
Fax (386) 322-3870
Taxonomy Code 225700000X
License State Florida
License Number MA52351
Remove 1104084300 NPI Number

According to our database, Mr. Ladon Stacy Lewis L.M.T. NPI is 1104084300, taxonomy code is 225700000X and license number is MA52351, license state is located at Florida. Ladon Stacy Lewis L.M.T. physically located at 3650 Nantucket Island Dr, Port Orange FL, 32129-5336. NPI Number Ladon Stacy Lewis L.M.T. has the Individual type.

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1104084300 NPI number is provided on an as is basis without warranty of any kind. 1104084300 is maintained by the National Plan & Provider Enumeration System. The contents of Ladon Stacy Lewis L.M.T. are for informational purposes only.