Individual
MARCIA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 BENT TREE DR APT 150, DAYTONA BEACH, FL 32114-1177
(470) 889-9521
Mailing address
100 BENT TREE DR APT 150, DAYTONA BEACH, FL 32114-1177
(470) 889-9521
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA79824
FL
Other
Enumeration date
11/16/2020
Last updated
11/16/2020
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