Individual
MRS. EVALENA KAYE MOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1304 S JEFFERSON ST, PERRY, FL 32348-4731
(850) 371-4395
Mailing address
1304 S JEFFERSON ST, PERRY, FL 32348-4731
(850) 371-4395
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA97342
FL
Other
Enumeration date
09/20/2023
Last updated
09/20/2023
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