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Individual

MRS. VICKY C ROYAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.M.T.

Contact information

Practice address
9274 NW 147TH WAY, LAKE BUTLER, FL 32054-4133
(386) 496-1033
Mailing address
9274 NW 147TH WAY, LAKE BUTLER, FL 32054-4133
(386) 496-1033

Taxonomy

Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA52046
FL

Other

Enumeration date
12/11/2007
Last updated
12/11/2007
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