Individual
MS. LAKISHA RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
10273 JOLYNN RD, JACKSONVILLE, FL 32225-6649
(904) 586-6940
Mailing address
10273 JOLYNN RD, JACKSONVILLE, FL 32225-6649
(904) 586-6940
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA100675
FL
Other
Enumeration date
11/28/2022
Last updated
11/28/2022
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