Individual
AUDRY BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5140 KEYSER MILL RD, BAKER, FL 32531-8354
(815) 557-3004
Mailing address
5140 KEYSER MILL RD, BAKER, FL 32531-8354
(815) 557-3004
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA97730
FL
Other
Enumeration date
04/26/2024
Last updated
04/26/2024
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