Individual
BATARA YUDHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
400 CARILLON PKWY, 130, ST PETERSBURG, FL 33716-1290
(727) 202-1222
Mailing address
4701 88TH AVE N APT 805, PINELLAS PARK, FL 33782-5722
(850) 319-5017
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA73451
FL
Other
Enumeration date
08/08/2013
Last updated
08/08/2013
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