Provider Demographics
NPI:1295886604
Name:ALBON, MICHELE R (LMT,LPTA,MMP,NMTC)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:R
Last Name:ALBON
Suffix:
Gender:F
Credentials:LMT,LPTA,MMP,NMTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 VILLAGE GREEN PKWY
Mailing Address - Street 2:SUITE 23
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-3404
Mailing Address - Country:US
Mailing Address - Phone:941-792-5828
Mailing Address - Fax:941-798-3942
Practice Address - Street 1:501 VILLAGE GREEN PKWY
Practice Address - Street 2:SUITE 23
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-3404
Practice Address - Country:US
Practice Address - Phone:941-792-5828
Practice Address - Fax:941-798-3942
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-13
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA28795225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist