Individual
IRICA ELANA DORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1488 S PALM AVE, PEMBROKE PINES, FL 33025-5520
(954) 213-5903
Mailing address
7360 BRANCH ST, HOLLYWOOD, FL 33024-5422
(954) 213-5903
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA50141
FL
Other
Enumeration date
10/14/2010
Last updated
10/14/2010
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