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Ms. Stacy R. Shidemantle, LMT
Massage Therapist in Fort Walton Beach, Florida
NPI 1598951378

Stacy R. Shidemantle is a Massage Therapist based in Fort Walton Beach, FL. Stacy R. Shidemantle practices in Fort Walton Beach, FL and has the professional credentials of LMT. The NPI Number for Stacy R. Shidemantle is 1598951378 and holds a License No. MA49802 (Florida).

The current practice location address for Stacy R. Shidemantle is 301 Sudduth Cir Ne, Fort Walton Beach, FL and can be reached out via phone at 850-543-4919.

Location: 301 Sudduth Cir Ne, Fort Walton Beach, FL, 32548-5124
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1598951378
Provider Name
Stacy R. Shidemantle
Credential
LMT
Provider Entity Type
Individual
Gender
Female
Address
301 Sudduth Cir Ne, Fort Walton Beach, FL, 32548-5124
Phone Number
850-543-4919
Fax Number
Provider Enumeration Date
09/14/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
301 Sudduth Cir Ne
City
Fort Walton Beach
State
Florida
Zip
32548-5124
Phone Number
850-543-4919
Fax Number
person
Provider Business Mailing Address Details
Address
301 Sudduth Cir Ne
City
Fort Walton Beach
State
Florida
Zip
32548-5124
Phone Number
850-543-4919
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
MA49802 (Florida)
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
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