Individual
LISA MATULKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA83905
Contact information
Practice address
3411 BONITA BEACH RD STE 305, BONITA SPRINGS, FL 34134-4155
(239) 529-7122
Mailing address
6020 JONATHANS BAY CIR APT 301, FORT MYERS, FL 33908-7255
(704) 860-4959
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA83905
FL
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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