Organization · Type 2 NPI

Lakewood Ranch Medical Massage, LLC

Massage Therapist · Bradenton, FL

NPI number 1104356591 Active

Practice location

9070 58th Dr E Ste 102
Bradenton, FL 34202-6110

Call (941) 321-5311 Map

Fax (941) 321-5311

Mailing address

11161 E State Road 70 Ste 110-360
Lakewood Ranch, FL 34202-9407

Specialties and licenses

Taxonomy	Code	License
Massage Therapist Primary	225700000X	MA40424 (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.

3 other providers at this address

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NPI record

NPI: 1104356591
Entity type: Organization (Type 2)
Issued: Jun 18, 2017
Last updated: Jun 18, 2017
Status: Active

Other names

<unavail>
Mad Science Massage · doing business as
Mad Science Massage · doing business as

Authorized official

Elizabeth Nicole Pugh, LMT
Owner / Therapist
(941) 321-5311

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104356591

Lakewood Ranch Medical Massage, LLC's National Provider Identifier is 1104356591, issued on Jun 18, 2017. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Bradenton, FL. The record was last updated on Jun 18, 2017.