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Individual

AMANDA LANE YOACHUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
155-8 BLANDING BLVD., ORANGE PARK, FL 32073
(904) 476-0258
(904) 213-9806
Mailing address
5378 WANDERING TRL, JACKSONVILLE, FL 32219-2718
(904) 476-0258
(904) 213-9806

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA50836
FL

Other

Enumeration date
06/29/2011
Last updated
06/29/2011
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