Individual
JENNIFER MCQUADE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1153 NE CLEVELAND ST, CLEARWATER, FL 33755-4815
(727) 599-6772
Mailing address
3232 COVENTRY N, SAFETY HARBOR, FL 34695-4807
(727) 599-6772
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA37275
FL
Other
Enumeration date
07/29/2012
Last updated
07/29/2012
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