Provider Demographics
NPI:1780097030
Name:TRIO FLOW WELLNESS, INC
Entity type:Organization
Organization Name:TRIO FLOW WELLNESS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LIZABETH
Authorized Official - Last Name:WHITLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, MMP
Authorized Official - Phone:239-207-0022
Mailing Address - Street 1:3811 AIRPORT RD N
Mailing Address - Street 2:SUITE 205A
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-2512
Mailing Address - Country:US
Mailing Address - Phone:239-207-0022
Mailing Address - Fax:
Practice Address - Street 1:14500 TAMIAMI TRL E
Practice Address - Street 2:LOT 106
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34114-8428
Practice Address - Country:US
Practice Address - Phone:239-207-0022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-04
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 46629225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty