Individual
JOHNSON BLAISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2648 W SR 434, SUITE C, LONGWOOD, FL 32779-4440
(407) 788-7778
(407) 788-7770
Mailing address
2648 W SR 434, SUITE C, LONGWOOD, FL 32779-4440
(407) 788-7778
(407) 788-7770
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA52522
FL
Other
Enumeration date
09/30/2008
Last updated
09/30/2008
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