Individual
MR. CHAD LEWIS WAINWRIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
7235 193RD RD, LIVE OAK, FL 32060-7857
(386) 688-3657
Mailing address
7235 193RD RD, LIVE OAK, FL 32060-7857
(386) 688-3657
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
59058
FL
Other
Enumeration date
05/17/2010
Last updated
05/17/2010
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