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Individual

LUIS Y MACIAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2440 HUNTER TER, FORT MYERS, FL 33901-7327
(786) 260-4903
Mailing address
2440 HUNTER TER, FORT MYERS, FL 33901-7327
(786) 260-4903

Taxonomy

Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
M220-539-74-066-0
FL

Other

Enumeration date
03/13/2012
Last updated
03/13/2012
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