NPI 1023206760

Kim G Anderson, LMT

Practitioner Massage Therapist Jacksonville, FL

Practice location

Address: 304 Ponce Blvd Suite 1, Jacksonville, FL 32218-3863
Phone: (904) 504-4563
Fax: (904) 751-3906
Mailing address: 11333 Vera Dr, Jacksonville, FL 32218-4159

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence MA30630 (FL)

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Registry record

NPI: 1023206760
Entity type: Individual
Sex (as registered): Female
NPI issued: 9 Oct 2007
Record last updated: 9 Oct 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.