Individual
JENNIFER LEE VAN WYNGAARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1797 OLD MOULTRIE RD STE 103, SAINT AUGUSTINE, FL 32084-5721
(904) 844-1616
Mailing address
255 WHISPERING WOODS LN APT 6, SAINT AUGUSTINE, FL 32084-5910
(904) 844-1616
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
97382
FL
Other
Enumeration date
04/30/2024
Last updated
04/30/2024
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