Individual
MR. LAWRENCE JERTBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
16824 NW 174TH TER, ALACHUA, FL 32615-4731
(386) 569-7801
(386) 462-4062
Mailing address
16824 NW 174TH TER, ALACHUA, FL 32615-4731
(386) 569-7801
(386) 462-4062
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA62326
FL
Other
Enumeration date
09/27/2012
Last updated
09/27/2012
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