Individual provider · Type 1 NPI

Stacey A. Chisholm, L.M.T.

Massage Therapist · New Smyrna Beach, FL

NPI number 1609013564 Active

Practice location

626 E 3rd Ave
New Smyrna Beach, FL 32169-3164

Call (386) 316-5313 Map

Mailing address

2459 Timberview Dr
New Smyrna Beach, FL 32168-8254

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X53499 (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 1609013564

Stacey A. Chisholm, L.M.T.'s National Provider Identifier is 1609013564, issued on Jan 14, 2009. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in New Smyrna Beach, FL. The record was last updated on Apr 10, 2013.