Provider Demographics
NPI:1285899575
Name:PARHAM, MARGO T (LMT)
Entity type:Individual
Prefix:MS
First Name:MARGO
Middle Name:T
Last Name:PARHAM
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 1:1111 STATE ROAD 436
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-6101
Mailing Address - Country:US
Mailing Address - Phone:407-925-5032
Mailing Address - Fax:407-679-2669
Practice Address - Street 1:1111 STATE ROAD 436
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-6101
Practice Address - Country:US
Practice Address - Phone:407-925-5032
Practice Address - Fax:407-679-2669
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA27594225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist