Doctor Name: | ALICE RUTH MCCONNELL |
NPI Number: | 1154537330 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.M.T. |
License Number: | MA40640 |
Business Practice Address: | 4554 E Highway 20 Niceville, FL - 325789755 |
Business Phone Number: | 8505820393 |
Business Fax Number: | |
Mailing Address: | 211 Walker Cir W, CRESTVIEW |
State: | FL |
Postal Code: | 325398339 |
Phone Number: | 8505820393 |
Fax Number: | |
NPI Enumeration Date: | 05/15/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA40640 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
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. |