Individual
MR. GREGORY HOUSTON NEELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
240 RIDGEWOOD AVE, HOLLY HILL, FL 32117-4944
(386) 492-2958
Mailing address
240 RIDGEWOOD AVE, HOLLY HILL, FL 32117-4944
(386) 492-2958
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA54198
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000832900
—
FL
Enumeration date
11/13/2008
Last updated
10/06/2009
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