Individual
MR. DAKOTA J GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2716 SUTTON BLVD, MAPLEWOOD, MO 63143-3036
(636) 399-4591
Mailing address
3428 LONGVIEW DR, SAINT LOUIS, MO 63129-1618
(636) 399-4591
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2018037470
MO
Other
Enumeration date
11/06/2024
Last updated
11/06/2024
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