Comprehensive Myofascial Therapy Associates, PA

NPI #1174765903 in Jacksonville, Florida

Provider Information

NPI Number: 1174765903
Entity Type: Organization
Organization Name: Comprehensive Myofascial Therapy Associates, PA
Primary Specialty: Physical Therapist
Enumeration Date: Mar 25, 2009
Last Updated: Mar 25, 2009

Practice Location

Address: 14546 OLD SAINT AUGUSTINE RD
Address 2: SUITE 403
City: Jacksonville
State: Florida
ZIP Code: 32258-5468
Phone: (904) 296-1500

Authorized Official

Name: MS. SHANNON PAGE GOOSSEN, AP, LMT
Title: PRESIDENT
Phone: (904) 296-1500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Acupuncturist	171100000X
Massage Therapist	225700000X
Physical Therapist	225100000X	Primary

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