Individual
MR. JOSHUA DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
3525 FURLONG WAY, FORT WORTH, TX 76244-5103
(682) 365-3638
Mailing address
3525 FURLONG WAY, FORT WORTH, TX 76244-5103
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT104862
TX
Other
Enumeration date
12/11/2014
Last updated
12/11/2014
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