Individual
MR. KENNETH EDWIN MUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1490 AVOCADO AVE, MELBOURNE, FL 32935-6532
(321) 252-5253
(888) 372-9707
Mailing address
1987 WALLACE AVE, MELBOURNE, FL 32935-3963
(321) 626-9055
(888) 372-9707
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA29049
FL
Other
Enumeration date
11/08/2011
Last updated
11/08/2011
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