Doctor Name: | MR. HALLIE WEBB |
NPI Number: | 1184950859 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.M.T. |
License Number: | MA53367 |
Business Practice Address: | 1200 W Avon Blvd Avon Park, FL - 338258343 |
Business Phone Number: | 8634432671 |
Business Fax Number: | |
Mailing Address: | 124 Hill Cir, LAKE WALES |
State: | FL |
Postal Code: | 338597552 |
Phone Number: | 8634432671 |
Fax Number: | |
NPI Enumeration Date: | 10/30/2009 |
NPI Last Update Date: | 10/30/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA53367 |
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. |