Provider Demographics
NPI:1467603902
Name:FOSSE, NATHALIE F (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:DR
First Name:NATHALIE
Middle Name:F
Last Name:FOSSE
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6307 NW 35TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32653-8821
Mailing Address - Country:US
Mailing Address - Phone:352-256-2800
Mailing Address - Fax:352-384-0771
Practice Address - Street 1:6307 NW 35TH TER
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32653-8821
Practice Address - Country:US
Practice Address - Phone:352-256-2800
Practice Address - Fax:352-384-0771
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA37616174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist