Individual
MR. ALEXANDER POLOUKINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1701 SE HILLMOOR DR, SUITE 1A, PORT ST LUCIE, FL 34952-7552
(772) 337-5511
Mailing address
710 SW BELMONT CIR, PORT ST LUCIE, FL 34953-6337
(772) 418-2220
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA40421
FL
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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