Doctor Name: | PEGGY L KESTERSON |
NPI Number: | 1881973808 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | MA #43091 |
Business Practice Address: | 1698 W Hibiscus Blvd Melbourne, FL - 329012639 |
Business Phone Number: | 3217686119 |
Business Fax Number: | 3217681710 |
Mailing Address: | Po Box 120786, MELBOURNE |
State: | FL |
Postal Code: | 329120786 |
Phone Number: | 3214121373 |
Fax Number: | 3213272668 |
NPI Enumeration Date: | 08/08/2011 |
NPI Last Update Date: | 08/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA #43091 |
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. |