Individual
BRANDI ELENA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
309 CHRISTIAN ST, STARKE, FL 32091-3129
(904) 769-8011
Mailing address
309 CHRISTIAN ST, STARKE, FL 32091-3129
(904) 769-8011
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA68226
FL
Other
Enumeration date
11/21/2016
Last updated
11/21/2016
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