Individual
JESSICA LYNN BROYLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
2929 NW 13TH ST, GAINESVILLE, FL 32609-2831
(352) 375-0295
Mailing address
3304 NW 20TH ST, GAINESVILLE, FL 32605-2420
(407) 739-5268
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA50989
FL
Other
Enumeration date
08/06/2007
Last updated
07/20/2009
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