Individual
MR. DANIEL EDWARD DE LA GARZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
6300 N WICKHAM RD, MELBOURNE, FL 32940-2028
(321) 536-2173
Mailing address
4872 OUTLOOK DR, MELBOURNE, FL 32940-2334
(321) 536-2173
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 47051
FL
Other
Enumeration date
08/20/2007
Last updated
08/20/2007
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