| NPI | 1881968451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSIE J DE LA PENA Massage Therapy 904-683-3205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL HCC9772) |
| Enumeration Date | 2012-02-29 |
| Last Update Date | 2012-02-29 |