Individual
MRS. KERRYE JOLYNN TABACZKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
110 N ORLANDO AVE, SUITE 14, MAITLAND, FL 32751-5574
(407) 647-1997
Mailing address
275 E PINE AVE, LONGWOOD, FL 32750-5282
(407) 694-8102
(407) 644-8184
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA47095
FL
Other
Enumeration date
12/03/2007
Last updated
12/03/2007
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