Organization
KRISTINE ISHAM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINE DYAN ISHAM (OWNER)
(772) 228-9638
Entity
Organization
Contact information
Practice address
709 SEBASTIAN BLVD STE G, SEBASTIAN, FL 32958-8704
(772) 228-9638
Mailing address
709 SEBASTIAN BLVD STE G, SEBASTIAN, FL 32958-8704
(772) 228-9638
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
04/10/2009
Last updated
04/10/2009
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