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Individual

BRENDA K KNOWLES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
4570 SAN JUAN AVE, SUITE 2, JACKSONVILLE, FL 32210-2051
(904) 388-8844
(904) 389-1170
Mailing address
4570 SAN JUAN AVE, SUITE 2, JACKSONVILLE, FL 32210-2051
(904) 388-8844
(904) 389-1170

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA25096
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C2645
BCBSFL
FL
Enumeration date
10/05/2006
Last updated
07/08/2007
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