Individual
MS. AMANDA J DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
403 LAFAYETTE ST, PORT ORANGE, FL 32127-4437
(386) 852-8737
(386) 868-5324
Mailing address
403 LAFAYETTE ST, PORT ORANGE, FL 32127-4437
(386) 852-8737
(386) 868-5324
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA49043
FL
Other
Enumeration date
10/06/2008
Last updated
10/06/2008
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