Provider Demographics
NPI:1053623793
Name:RUNHAAR, ERIN ELIZABETH (LMT)
Entity type:Individual
Prefix:MISS
First Name:ERIN
Middle Name:ELIZABETH
Last Name:RUNHAAR
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 1:5136 MAJORCA CLUB DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-8705
Mailing Address - Country:US
Mailing Address - Phone:561-901-1731
Mailing Address - Fax:
Practice Address - Street 1:4905 LANTANA ROAD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-8705
Practice Address - Country:US
Practice Address - Phone:561-901-1731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-10
Last Update Date:2010-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 31687225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist