Individual
MARYBETH DYCKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
165 SOUTHPARK BLVD, SUITE C AND D, ST AUGUSTINE, FL 32086-4101
(904) 823-8833
Mailing address
130 13TH ST, ST AUGUSTINE, FL 32080-6362
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA58305
FL
Other
Enumeration date
03/18/2011
Last updated
03/18/2011
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