Individual
ALLEN MICHAEL FORTIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2140 SW LARCHMONT LN, PORT SAINT LUCIE, FL 34984-4321
(954) 634-2501
Mailing address
2140 SW LARCHMONT LN, PORT SAINT LUCIE, FL 34984-4321
(772) 634-0252
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA64378
FL
Other
Enumeration date
02/05/2024
Last updated
02/05/2024
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