Johnson Blaise, LMT

NPI #1518117225 in Longwood, Florida

Provider Information

NPI Number
1518117225
Entity Type
Individual
Name
Johnson Blaise, LMT
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Massage Therapist
Credential
LMT
Enumeration Date
Sep 30, 2008
Last Updated
Sep 30, 2008

Practice Location

Address
2648 W SR 434
Address 2
SUITE C
State
Florida
ZIP Code
32779-4440
Phone
(407) 788-7778

Specialties & Taxonomy Codes

Specialty
Massage Therapist

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