Provider Demographics
NPI:1558199901
Name:LANGLEY, JAMES
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:LANGLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4685 N HAVERHILL RD APT D12
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-8362
Mailing Address - Country:US
Mailing Address - Phone:443-643-6912
Mailing Address - Fax:
Practice Address - Street 1:3944 FLORIDA BLVD STE 103
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-2271
Practice Address - Country:US
Practice Address - Phone:561-782-5868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist