Individual
MR. JONATHAN GALLUP GALLUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2212 CLEVELAND AVE, FORT MYERS, FL 33901-3501
(941) 268-9653
Mailing address
25334 JUBAL ST, PUNTA GORDA, FL 33955-4251
(941) 575-7636
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA52036
FL
Other
Enumeration date
01/22/2008
Last updated
01/22/2008
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