Individual
ALICE RUTH MCCONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
4554 E HIGHWAY 20, NICEVILLE, FL 32578-9755
(850) 582-0393
Mailing address
211 WALKER CIR W, CRESTVIEW, FL 32539-8339
(850) 582-0393
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA40640
FL
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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