Individual
MR. MATTHEW J MICHAUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
3864 SAN JOSE PARK DRIVE, JACKSONVILLE, FL 32217
(904) 737-8552
(904) 737-8113
Mailing address
3864 SAN JOSE PARK DRIVE, JACKSONVILLE, FL 32217
(904) 737-8552
(904) 737-8113
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA23394
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA23394
LMT
FL
Enumeration date
10/10/2006
Last updated
07/08/2007
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