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Individual

GARY THOMAS WATERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.M.T.

Contact information

Practice address
9719 DEAN ACRE CT, ORLANDO, FL 32825-6557
(407) 497-9235
(407) 249-2167
Mailing address
9719 DEAN ACRE CT, ORLANDO, FL 32825-6557
(407) 497-9235
(407) 249-2167

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA24290
FL

Other

Enumeration date
09/26/2007
Last updated
09/26/2007
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