MR. KENNETH WAYNE WALDBURG JR.
NPI 1316712698
Massage Therapist in Jacksonville, FL
- Individual
- Male
- Massage Therapist
About KENNETH WALDBURG
This page provides the complete NPI Profile along with additional information for Kenneth Waldburg, a provider established in Jacksonville, Florida with a medical specialization in Massage Therapist. The healthcare provider is registered in the NPI registry with number 1316712698 assigned on November 2023. The practitioner's primary taxonomy code is 225700000X with license number MA62122 (FL). The provider is registered as an individual and his NPI record was last updated 3 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization.
- NPI
- 1316712698 Verify this NPI
- Provider Name
- MR. KENNETH WAYNE WALDBURG JR.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 4629 GERBER CT JACKSONVILLE, FL 32210
- Location Phone
- (904) 790-3671
- Mailing Address
- 4629 GERBER CT JACKSONVILLE, FL 32210
- Mailing Phone
- (904) 790-3671
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 11-16-2023
- Last Update Date
- 11-16-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Massage Therapist
- Taxonomy Code
- 225700000X
- Type
- Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- License No.
- MA62122
- License State
- FL
- Taxonomy Description
- 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.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1316712698, enumerated as an "individual" on November 16, 2023.
The provider is located at 4629 GERBER CT JACKSONVILLE, FL 32210 and the phone number is (904) 790-3671.
Massage Therapist with taxonomy code 225700000X.
