Provider Demographics
NPI:1457556540
Name:LAMBKINHEIGHT, VIRGINIA (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:LAMBKINHEIGHT
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 1:236 N GROVE ST
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-3444
Mailing Address - Country:US
Mailing Address - Phone:321-452-7373
Mailing Address - Fax:321-452-7373
Practice Address - Street 1:236 N GROVE ST
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-3444
Practice Address - Country:US
Practice Address - Phone:321-452-7373
Practice Address - Fax:321-452-7373
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA16520174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist