Individual
LORI JEAN CLISSOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10033 DR MARTIN LUTHER KING JR ST N STE 300, ST PETERSBURG, FL 33716-3830
(727) 498-8898
(727) 800-6959
Mailing address
301 W PLATT ST STE 24, TAMPA, FL 33606-2292
(727) 498-8898
(727) 800-6959
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 64886
FL
Other
Enumeration date
04/03/2014
Last updated
04/07/2014
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