Individual
MRS. JULIE ANNE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1982 ROCKLEDGE BLVD STE 102, ROCKLEDGE, FL 32955-3760
(321) 631-5366
Mailing address
1263 CREEK SIDE CIR, ROCKLEDGE, FL 32955-8229
(321) 960-3977
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA#52991
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA#52991
DEPARTMENT OF HEALTH - MASSAGE THERAPY LICENSURE
FL
Enumeration date
11/19/2008
Last updated
11/19/2008
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