Ms Stacy R Shidemantle, LMT | |
301 Sudduth Cir Ne, Fort Walton Beach, FL 32548-5124 | |
(850) 543-4919 | |
Not Available |
Full Name | Ms Stacy R Shidemantle |
---|---|
Gender | Female |
Speciality | Massage Therapist |
Location | 301 Sudduth Cir Ne, Fort Walton Beach, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1598951378 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225700000X | Massage Therapist | MA49802 (Florida) | Primary |
Mailing Address | Practice Location Address |
---|---|
Ms Stacy R Shidemantle, LMT 301 Sudduth Cir Ne, Fort Walton Beach, FL 32548-5124 Ph: (850) 543-4919 | Ms Stacy R Shidemantle, LMT 301 Sudduth Cir Ne, Fort Walton Beach, FL 32548-5124 Ph: (850) 543-4919 |
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