Individual
JAMIE LYNN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5998 CENTRE ST, SUITE E, MELROSE, FL 32666-6208
(352) 475-1013
Mailing address
PO BOX 583, MELROSE, FL 32666-0583
(352) 475-1013
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA42383
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C2825
BLUE CROSS BLUE SHIELD OF FLORIDA
FL
Enumeration date
03/13/2012
Last updated
03/13/2012
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