| Doctor Name: | MS. KATHERINE SOO TIAN TAN |
| NPI Number: | 1306977590 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | MA43645 |
| Business Practice Address: | 570 Ocean Dr Holistic Manage & Wellness Clinics # 501 Juno Beach, FL - 33408 |
| Business Phone Number: | 9544912225 |
| Business Fax Number: | 9544916862 |
| Mailing Address: | 1501 South Ocean Drive, Apt 803 HOLLYWOOD |
| State: | FL |
| Postal Code: | 330192369 |
| Phone Number: | 9549223918 |
| Fax Number: | |
| NPI Enumeration Date: | 03/08/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225700000X |
| License Number: | MA43645 |
| 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. |