Individual
MR. MARK ANTHONY KERESTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1135 NW 23RD AVE, SUITE F, GAINESVILLE, FL 32609-5415
(352) 376-8410
Mailing address
3855 NW 36TH PL, GAINESVILLE, FL 32606-8139
(352) 373-6165
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 0017566
FL
Other
Enumeration date
02/20/2007
Last updated
07/08/2007
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