Individual
MISS MARIELLE GRACE SHOFFSTALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
10401 US HIGHWAY 441, SUITE 326, LEESBURG, FL 34788-8787
(352) 365-6155
Mailing address
10218 MISTY MEADOW RD, LEESBURG, FL 34788-3300
(352) 617-5121
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA48313
FL
Other
Enumeration date
07/28/2008
Last updated
07/28/2008
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