Individual
DEANNA DARNELL SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
118 OHIO AVE N STE A, LIVE OAK, FL 32064-2464
(386) 243-5805
Mailing address
PO BOX 70, JASPER, FL 32052-0070
(386) 397-0884
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA103124
FL
Other
Enumeration date
07/13/2023
Last updated
07/13/2023
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