Provider Demographics
NPI:1053529222
Name:THE FORD GROUP, LMT
Entity type:Organization
Organization Name:THE FORD GROUP, LMT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MASSAGE THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:AURORA
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:1386-679-7577
Mailing Address - Street 1:17 REMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-2528
Mailing Address - Country:US
Mailing Address - Phone:386-437-4221
Mailing Address - Fax:
Practice Address - Street 1:555 W GRANADA BLVD
Practice Address - Street 2:SUITE G6
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-9485
Practice Address - Country:US
Practice Address - Phone:386-677-7123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL07-20029173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty