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Individual

JAMESON SELF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
330 PAULS DR, SUITE 102, BRANDON, FL 33511-4801
(813) 643-1242
Mailing address
330 PAULS DR, SUITE 102, BRANDON, FL 33511-4801
(813) 643-1242

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 57055
FL

Other

Enumeration date
11/22/2010
Last updated
11/22/2010
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