Individual
SAMUEL DAVID PACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSCD, LMT
Contact information
Practice address
4209-1 UNIVERSITY BLVD S, JACKSONVILLE, FL 32216-4907
(904) 737-9553
Mailing address
4209-1 UNIVERSITY BLVD S, JACKSONVILLE, FL 32216-4907
(904) 737-9553
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA20387
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M9926
MASSGE ESTABLISHMENT
FL
01
—
MA30387
MASSAGE THEAPY LICENSE
FL
Enumeration date
03/19/2007
Last updated
07/08/2007
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