Provider Demographics
NPI:1912238825
Name:BOYD, MARIE-JOSEE PEGGY (LMT)
Entity Type:Individual
Prefix:MRS
First Name:MARIE-JOSEE
Middle Name:PEGGY
Last Name:BOYD
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 1:156 WHITAKER RD STE B
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-5792
Mailing Address - Country:US
Mailing Address - Phone:813-948-6300
Mailing Address - Fax:
Practice Address - Street 1:156 WHITAKER RD STE B
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-5792
Practice Address - Country:US
Practice Address - Phone:813-948-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-18
Last Update Date:2010-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26378225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist