Individual
LIUVAN CORRALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1914 N HIMES AVE, TAMPA, FL 33607-4219
(813) 374-9142
(813) 374-9144
Mailing address
1914 N HIMES AVE, TAMPA, FL 33607-4219
(813) 374-9142
(813) 374-9144
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
56369
FL
Other
Enumeration date
06/17/2009
Last updated
06/17/2009
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