Provider Demographics
NPI:1902314768
Name:TURCO, KATRINA LYNN (LMT)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:LYNN
Last Name:TURCO
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 1:3929 CREEK WOODS DR
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-4087
Mailing Address - Country:US
Mailing Address - Phone:813-720-1510
Mailing Address - Fax:
Practice Address - Street 1:1514 S ALEXANDER ST STE 102
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-8417
Practice Address - Country:US
Practice Address - Phone:813-720-1510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-16
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA87666225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist