Provider Demographics
NPI:1295855260
Name:TURNER, WESLEY ERIC
Entity Type:Individual
Prefix:MR
First Name:WESLEY
Middle Name:ERIC
Last Name:TURNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 RANDALL ROBERTS RD
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-1921
Mailing Address - Country:US
Mailing Address - Phone:850-315-0100
Mailing Address - Fax:850-315-0100
Practice Address - Street 1:634 RANDALL ROBERTS RD
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-1921
Practice Address - Country:US
Practice Address - Phone:850-315-0100
Practice Address - Fax:850-315-0100
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA31366225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist