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Individual

MS. ILANA FAITH SPODAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.M.T., C.N.M.T.

Contact information

Practice address
201 SE 15TH TER, SUITE 212, DEERFIELD BEACH, FL 33441-4464
(561) 642-1408
Mailing address
201 SE 15TH TER, SUITE 212, DEERFIELD BEACH, FL 33441-4464
(954) 288-6375

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 23450
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MA 23450
FLORIDA BOARD OF MASSAGE THERAPY
FL
Enumeration date
03/15/2007
Last updated
03/04/2015
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