Individual
JESSICA WILLOUGHBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4350 STORY RD, SAINT CLOUD, FL 34772-9098
(407) 873-9579
Mailing address
4350 STORY RD, SAINT CLOUD, FL 34772-9098
(407) 873-9579
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
69290
FL
Other
Enumeration date
09/20/2016
Last updated
09/20/2016
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