Individual
MR. KENNETH WAYNE WALDBURG JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4629 GERBER CT, JACKSONVILLE, FL 32210-1411
(904) 790-3671
Mailing address
4629 GERBER CT, JACKSONVILLE, FL 32210-1411
(904) 790-3671
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA62122
FL
Other
Enumeration date
11/16/2023
Last updated
11/16/2023
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