NPI 1104669704 · live from the CMS NPI Registry
William S Allen, LMT
Massage Therapist in Orange Park, FL. National Provider Identifier 1104669704, active.
NPI record
| NPI | 1104669704 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Massage Therapist 225700000X |
| Practice location | 179 College Dr Ste 16, Orange Park, FL 32065 |
| Practice phone | 352-283-5864 |
| Mailing address | 5005 Spearmint St, Middleburg, FL 32068 |
| Enumerated | June 13, 2024 |
| Last updated | June 13, 2024 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist primary | 225700000X | 100828 (FL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.