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Individual

JOHN FRANK STEPHENS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
49 S ATLANTIC AVE, COCOA BEACH, FL 32931-2713
(312) 783-5592
(321) 783-0558
Mailing address
1312 SAINT ANDREWS DR, ROCKLEDGE, FL 32955-2529
(321) 635-8219

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA12199
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C7271
BLUE CROSS BLUE SHIELD
FL
01
MA12199
FL MASSAGE LICENSE NUMBER
FL
Enumeration date
01/20/2007
Last updated
07/08/2007
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