Individual
JUAN A VELASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
96 SUMMER ST APT 3, REVERE, MA 02151-4276
(781) 215-4064
Mailing address
96 SUMMER ST APT 3, REVERE, MA 02151-4276
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
17048
MA
Other
Enumeration date
11/03/2021
Last updated
11/03/2021
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