Individual
GERRODDICKA L HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
8923 AVENUE CLUB DR UNIT 202, TEMPLE TERRACE, FL 33637-5840
(813) 965-5276
Mailing address
8923 AVENUE CLUB DR UNIT 202, TEMPLE TERRACE, FL 33637-5840
(813) 965-5276
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA69393
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H620292867250
LICENSE
FL
Enumeration date
04/22/2022
Last updated
04/22/2022
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