Individual
MR. JEREMY ARTHUR MINNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2143 NW 17TH AVE, CAPE CORAL, FL 33993-3101
(239) 671-9900
(239) 772-0146
Mailing address
2143 NW 17TH AVE, CAPE CORAL, FL 33993-3101
(239) 671-9900
(239) 772-0146
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 25921
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C3738
BCBS OF FL.
FL
Enumeration date
09/22/2006
Last updated
07/19/2012
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