Individual
DANIEL S PUTNAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1437 FLAGLER AVE, JACKSONVILLE, FL 32207-8516
(904) 982-4336
(800) 350-7636
Mailing address
PO BOX 380066, JACKSONVILLE, FL 32205-0566
(904) 982-4336
(800) 350-7636
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA0022782
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C7661
BCBS OF FL PROVIDER #
FL
01
—
MA0022782
FLORIDA LICENSE #
FL
Enumeration date
06/07/2007
Last updated
07/08/2007
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