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Individual

JESSY KIMBRELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5967 FOLKSTONE LN, ORLANDO, FL 32822-9420
(954) 815-1301
Mailing address
5967 FOLKSTONE LN, ORLANDO, FL 32822-9420

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA92290
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MA92290
MASSAGE LICENSE
FL
Enumeration date
09/23/2020
Last updated
09/23/2020
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