Individual
MARTHA TELLEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1241 BLANDING BLVD, ORANGE PARK, FL 32065-5906
(904) 982-4047
Mailing address
341 GANO AVE, ORANGE PARK, FL 32073-4309
(904) 982-4047
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA48362
FL
Other
Enumeration date
09/13/2007
Last updated
09/13/2007
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