Individual
MRS. JAMIE LYNN GRUBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
1206 SW MAIN BLVD, SUITE 103, LAKE CITY, FL 32025-6684
(386) 719-2500
(386) 719-2500
Mailing address
1206 SW MAIN BLVD, SUITE 103, LAKE CITY, FL 32025-6684
(386) 719-2500
(386) 719-2500
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA25483
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C8329
BLUE CROSS BLUE SHIELD PR
FL
Enumeration date
07/27/2006
Last updated
07/08/2007
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