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MR. LAWRENCE JERTBERG L.M.T.
>> Massage Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1245581404
Individual Registrant:MR. LAWRENCE JERTBERG L.M.T.
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
16824 NW 174TH TER ALACHUA, FL 32615-4731 US
Tel: 386-569-7801 Fax: 386-462-4062
Tel: 386-569-7801 Fax: 386-462-4062
Contact information for business:
16824 NW 174TH TER ALACHUA, FL 32615-4731 US
Tel: 386-569-7801 Fax: 386-462-4062
Tel: 386-569-7801 Fax: 386-462-4062
Registration Information:
NPI: 1245581404
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 225700000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Massage Therapist | FL | MA62326 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
