Individual
AVVONLEA JOHNNIE GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
305 S ISEMINGER ST APT 6, PHILADELPHIA, PA 19107-5952
(806) 535-3723
Mailing address
305 S ISEMINGER ST APT 6, PHILADELPHIA, PA 19107-5952
(806) 535-3723
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MSG014562
PA
Other
Enumeration date
03/22/2022
Last updated
03/22/2022
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