Provider Demographics
NPI:1609012137
Name:RAINFORD, NANCY T (LMT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:T
Last Name:RAINFORD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1958 SE HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-5812
Mailing Address - Country:US
Mailing Address - Phone:772-215-3564
Mailing Address - Fax:772-463-3653
Practice Address - Street 1:1958 SE HARRISON ST
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-5812
Practice Address - Country:US
Practice Address - Phone:772-215-3564
Practice Address - Fax:772-463-3653
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA48789225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist