Individual
KEITH MARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4154 HERSCHEL ST, JACKSONVILLE, FL 32210-2244
(904) 689-7344
Mailing address
4154 HERSCHEL ST, JACKSONVILLE, FL 32210-2244
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA38789
FL
Other
Enumeration date
11/29/2011
Last updated
11/29/2011
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