Individual
EILEEN LASSITER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
51C CORDOVA ST, ST AUGUSTINE, FL 32084-3628
(904) 829-0590
Mailing address
6831 SANDALWOOD LN, NAPLES, FL 34109-0511
(904) 910-8811
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA62944
FL
Other
Enumeration date
07/08/2013
Last updated
07/08/2013
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