Provider Demographics
NPI:1699413310
Name:STREETMAN, MARGRET (LMT, CPP, CKTS)
Entity Type:Individual
Prefix:
First Name:MARGRET
Middle Name:
Last Name:STREETMAN
Suffix:
Gender:F
Credentials:LMT, CPP, CKTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20179 THE GRANADA
Mailing Address - Street 2:
Mailing Address - City:DUNNELLON
Mailing Address - State:FL
Mailing Address - Zip Code:34432-6047
Mailing Address - Country:US
Mailing Address - Phone:352-292-6361
Mailing Address - Fax:
Practice Address - Street 1:520 E FORT KING ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-2267
Practice Address - Country:US
Practice Address - Phone:352-292-6361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA85952225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist