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MR. LAWRENCE JERTBERG L.M.T.

>> Massage Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1245581404

Individual Registrant:
MR. LAWRENCE  JERTBERG L.M.T.
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

Contact information for business:
16824 NW 174TH TER  ALACHUA, FL 32615-4731 US
Tel: 386-569-7801  Fax: 386-462-4062

Registration Information:
NPI: 1245581404
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225700000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Massage Therapist
FLMA62326

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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