Individual
MR. MARK EDWARD KOCHKODAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2415 N DIXIE HWY, WILTON MANORS, FL 33305-2239
(954) 563-0001
Mailing address
2415 N. DIXIE HWY, CHI SPA, WILTON MANORS, FL 33305
(954) 563-0001
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA31242
FL
Other
Enumeration date
06/12/2008
Last updated
11/02/2016
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