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Individual

MR. GARY PELOQUIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
1830 NE DIXIE HWY, JENSEN BEACH, FL 34957-6445
(772) 225-5555
(772) 225-0675
Mailing address
1830 NE DIXIE HWY, JENSEN BEACH, FL 34957-6445
(772) 225-5555
(772) 225-0675

Taxonomy

Speciality
Code
Description
License number
State
173C00000X
Reflexologist
Primary
MA23030
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MA23030
STATE MASSAGE THERAPY LICENSE
FL
Enumeration date
08/15/2009
Last updated
08/15/2009
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