Individual
MAVIS BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11740-2 SAN JOSE BLVD, JACKSONVILLE, FL 32223-1629
(904) 880-5755
Mailing address
12074 COACHMAN MEADOWS DR, JACKSONVILLE, FL 32246-0559
(904) 553-1103
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA#69139
FL
Other
Enumeration date
04/22/2015
Last updated
04/22/2015
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