Doctor Name: | MS. ELISHA DEBORAH KOOTA |
NPI Number: | 1497074496 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | A.P. |
License Number: | MA43216 |
Business Practice Address: | 3841 Nw 35th St # 1521 Coconut Creek, FL - 330662408 |
Business Phone Number: | 9544648757 |
Business Fax Number: | |
Mailing Address: | 3841 Nw 35th St # 1521, COCONUT CREEK |
State: | FL |
Postal Code: | 330662408 |
Phone Number: | 9544648757 |
Fax Number: | |
NPI Enumeration Date: | 05/31/2010 |
NPI Last Update Date: | 05/31/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA43216 |
Healthcare Provider Taxonomy: (Secondary) | N |
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. |