Individual
IKUKO ENRIQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7692 SUNNYDALE LN, JACKSONVILLE, FL 32256-1961
(928) 444-3811
Mailing address
7692 SUNNYDALE LN, JACKSONVILLE, FL 32256-1961
(928) 444-3811
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA98715
FL
Other
Enumeration date
06/10/2022
Last updated
06/10/2022
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