Individual
MS. MARY A LANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
210 MOODY BLVD, FLAGLER BEACH, FL 32136-3372
(386) 439-6933
(386) 439-6605
Mailing address
PO BOX 1853, FLAGLER BEACH, FL 32136-1853
(386) 439-6933
(386) 439-6605
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA0012657
FL
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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