Individual
ELIZABETH ANN OLDHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, FS, RCA
Contact information
Practice address
5636 CHERRY LN, BUNNELL, FL 32110-4664
(772) 882-1925
Mailing address
5636 CHERRY LN, BUNNELL, FL 32110-4664
(772) 882-1925
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA63726
FL
Other
Enumeration date
01/12/2015
Last updated
04/10/2017
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