Individual
KISHA N WHITEHURST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2469 QUARTERHORSE TRL, MIDDLEBURG, FL 32068-4428
(904) 718-2289
Mailing address
2469 QUARTERHORSE TRL, MIDDLEBURG, FL 32068-4428
(904) 718-2289
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA47060
FL
Other
Enumeration date
11/12/2010
Last updated
11/12/2010
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