Individual
JAVIER HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1001 12TH AVE STE 201, FORT WORTH, TX 76104-3946
(817) 719-7714
Mailing address
1001 12TH AVE, FORT WORTH, TX 76104-3926
(817) 719-7714
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT135347
TX
Other
Enumeration date
10/01/2021
Last updated
08/29/2023
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