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Individual

MRS. CELESTE PONUSHIS MCCRORY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.M.T.

Contact information

Practice address
488 S HUNT CLUB BLVD, APOPKA, FL 32703-4948
(407) 497-7353
Mailing address
PO BOX 915065, LONGWOOD, FL 32791-5065
(407) 497-7353

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 26527
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C2452
BLUE CROSS/BLUE SHIELD
FL
Enumeration date
05/02/2009
Last updated
05/02/2009
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