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Individual

D R VENCIL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
1700 SAN PABLO RD S, #301, JACKSONVILLE, FL 32224-2063
(904) 233-6526
Mailing address
1700 SAN PABLO RD S, #301, JACKSONVILLE, FL 32224-2063
(904) 233-6526

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 31662
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MA31662
LICENSE NUMBER
FL
Enumeration date
08/03/2006
Last updated
07/08/2007
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