Individual
MR. IAN LW TERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
1161 ISLAND SHORE LN, APT #231, LAKE MARY, FL 32746-5396
(321) 262-3905
Mailing address
1161 ISLAND SHORE LN, APT #231, LAKE MARY, FL 32746-5396
(321) 262-3905
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA56779
FL
Other
Enumeration date
10/16/2009
Last updated
04/06/2010
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