Individual
IDRIS JAMAL THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
803 E JAMES ST, TAMPA, FL 33603-5005
(317) 201-4249
Mailing address
803 E JAMES ST, TAMPA, FL 33603-5005
(317) 201-4249
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA102982
FL
Other
Enumeration date
10/27/2023
Last updated
10/27/2023
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