Individual provider · Type 1 NPI
Bo Gong
Massage Therapist · Melbourne, FL
NPI number
1407115835
Active
Practice location
6559 N Wickham Rd # C-103
Melbourne, FL 32940-2052
Mailing address
2579 Oak St
Kissimmee, FL 34744-4946
Other practice locations
- 2579 Oak St, Kissimmee, FL 34744-4946 · (407) 288-4865
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist Primary | 225700000X | MA68483 (FL) |
| Student in an Organized Health Care Education/Training Program | 390200000X | MA68483 (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 1407115835
Bo Gong's National Provider Identifier is 1407115835, issued on May 4, 2012. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Melbourne, FL. The record was last updated on Feb 4, 2025.