Individual
JOHNNY T WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2571 W EAU GALLIE BLVD STE 3, MELBOURNE, FL 32935-8302
(321) 806-0203
Mailing address
2571 W EAU GALLIE BLVD STE 3, MELBOURNE, FL 32935-8302
(321) 806-0203
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA67692
FL
Other
Enumeration date
03/02/2013
Last updated
03/02/2013
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