Individual
JAMUS GRANDSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7505 S SPARKMAN ST, TAMPA, FL 33616-2152
(813) 340-6720
Mailing address
7505 S SPARKMAN ST, TAMPA, FL 33616-2152
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA102007
FL
Other
Enumeration date
02/08/2023
Last updated
02/08/2023
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