Individual
MS. LENNIE GRACE PENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
635 S WICKHAM RD, SUITE 203, W MELBOURNE, FL 32904-1436
(321) 723-1011
(321) 723-1110
Mailing address
5141 PALOMINO DR, MELBOURNE, FL 32934-7844
(321) 259-4853
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
23182
FL
Other
Enumeration date
09/29/2010
Last updated
09/29/2010
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