Individual
GILDA OTILIA LEGACY KWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.M.
Contact information
Practice address
4367 LYNX PAW TRL, VALRICO, FL 33594-7426
(813) 657-2640
(813) 657-2685
Mailing address
2541 MASON OAKS DR, VALRICO, FL 33594-6498
(813) 657-2640
(813) 657-2685
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AP2219
FL
Other
Enumeration date
07/03/2006
Last updated
07/08/2007
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