Doctor Name: | GEORGE DOSDOS SACLA |
NPI Number: | 1689818742 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMT |
License Number: | MA 39398 |
Business Practice Address: | 339 Racetrack Rd Nw Suite 12 Fort Walton Beach, FL - 325471538 |
Business Phone Number: | 8503683393 |
Business Fax Number: | 8503985923 |
Mailing Address: | 339 Racetrack Rd Nw, Suite 12 FORT WALTON BEACH |
State: | FL |
Postal Code: | 325471538 |
Phone Number: | 8503683393 |
Fax Number: | 8503985923 |
NPI Enumeration Date: | 04/20/2009 |
NPI Last Update Date: | 04/20/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA 39398 |
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. |