Individual
MRS. KIMBERLY ANN REAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, CMLDT
Contact information
Practice address
7530 103RD STREERT, SUITE 13, JACKSONVILLE, FL 32210
(904) 318-4957
Mailing address
7530 103RD ST STE 13, JACKSONVILLE, FL 32210-6786
(904) 318-4957
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA31726
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA31726
PERSONAL LICENSE #
FL
01
—
MM44961
ESTABLISHMENT LICENSE
FL
Enumeration date
12/28/2009
Last updated
05/24/2024
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