Doctor Name: | VITIA ANGELA PACK |
NPI Number: | 1013133826 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICENSED MASSAGE THE |
License Number: | |
Business Practice Address: | 2295 N University Dr Pembroke Pines, FL - 330243611 |
Business Phone Number: | 9549831969 |
Business Fax Number: | 9549831980 |
Mailing Address: | 7800 W Oakland Park Blvd, Suite E-214 SUNRISE |
State: | FL |
Postal Code: | 333516741 |
Phone Number: | 9543186590 |
Fax Number: | 9543186604 |
NPI Enumeration Date: | 04/18/2007 |
NPI Last Update Date: | 04/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |