Individual
MR. WILLIAM JOACHIM MACISAAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
11535 MOUNTAIN BAY DR, RIVERVIEW, FL 33569-2044
(813) 389-6503
Mailing address
11535 MOUNTAIN BAY DR, RIVERVIEW, FL 33569-2044
(813) 389-6503
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA46203
FL
Other
Enumeration date
06/22/2010
Last updated
06/22/2010
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