Individual
MR. FELIX ELIZAGA MORA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, NMT
Contact information
Practice address
468 PORTSDALE DR, BRENTWOOD, TN 37027-1548
(310) 404-1003
Mailing address
468 PORTSDALE DR, BRENTWOOD, TN 37027-1548
(310) 404-1003
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12845
TN
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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