Organization
AVANT GARDE SALON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL JOSEPH MOOK LMT (OWNER)
(352) 376-0037
Entity
Organization
Contact information
Practice address
1310 SW 13TH ST, SUITE G, GAINESVILLE, FL 32608-1121
(352) 376-0037
Mailing address
1310 SW 13TH ST, SUITE G, GAINESVILLE, FL 32608-1121
(352) 376-0037
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
06/15/2011
Last updated
06/15/2011
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