Individual
LAURA INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4440 LAFAYETTE ST, SUITE K, MARIANNA, FL 32446-3410
(850) 482-0082
(850) 482-0095
Mailing address
4440 LAFAYETTE ST, SUITE K, MARIANNA, FL 32446-3410
(850) 209-8388
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA48057
FL
Other
Enumeration date
09/06/2006
Last updated
07/08/2007
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