Individual
MR. WENDELL DIAMAL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
17307 PAGONIA DR, SUITE 100, CLERMONT, FL 34711-5932
(407) 346-0506
Mailing address
17307 PAGONIA DR, SUITE 100, CLERMONT, FL 34711-5932
(407) 346-0506
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA33391
FL
225700000X
Massage Therapist
MA33391
FL
Other
Enumeration date
01/30/2014
Last updated
01/30/2014
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