Individual
LINDA NELL PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
531 ATLANTIC BLVD, SUITE 5, ATLANTIC BEACH, FL 32233-4022
(904) 416-6633
Mailing address
531 ATLANTIC BLVD, SUITE 5, ATLANTIC BEACH, FL 32233-4022
(904) 416-6633
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA57377
FL
Other
Enumeration date
09/24/2012
Last updated
09/24/2012
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