Individual provider · Type 1 NPI

Ladon Stacy Lewis, L.M.T.

Massage Therapist · Port Orange, FL

NPI number 1104084300 Active

Practice location

3650 Nantucket Island Dr, Apt. 101
Port Orange, FL 32129-5336

Call (386) 679-4996 Map

Fax (386) 322-3870

Mailing address

PO Box 422
Daytona Beach, FL 32115-0422

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000XMA52351 (FL)

Massage Therapist: 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.

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About NPI 1104084300

Ladon Stacy Lewis, L.M.T.'s National Provider Identifier is 1104084300, issued on May 26, 2008. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Port Orange, FL. The record was last updated on May 26, 2008.