Individual
KESARA MAI NGAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
117 WEST OAK DRIVE, LAKELAND, FL 33803
(863) 812-9388
Mailing address
117 W OAK DR, LAKELAND, FL 33803-3808
(863) 812-9388
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA78493
FL
Other
Enumeration date
10/02/2017
Last updated
10/02/2017
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