Individual
JESSICA M FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T
Contact information
Practice address
555 W GRANADA BLVD STE G6, ORMOND BEACH, FL 32174-9408
(386) 405-5295
Mailing address
555 W GRANADA BLVD STE G6, ORMOND BEACH, FL 32174-9408
(386) 405-5295
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 50220
FL
Other
Enumeration date
08/29/2012
Last updated
08/29/2012
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