Individual
JALIECE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4090 HODGES BLVD APT 510, JACKSONVILLE, FL 32224-4206
(904) 322-0702
Mailing address
4090 HODGES BLVD APT 510, JACKSONVILLE, FL 32224-4206
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA75084
FL
Other
Enumeration date
08/04/2021
Last updated
08/04/2021
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