Stacy R. Shidemantle, LMT Valid NPI

Individual provider · Massage Therapist · Fort Walton Beach, FL

NPI

1598951378

Type

Individual (Type 1)

Primary specialty

Massage Therapist

Specialty group

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy code

225700000X

License number

MA49802 (FL)

Sex

Female

Sole proprietor

Yes

Enumerated

2007-09-14

Last updated

2007-09-14