Individual provider · NPI-1

Daniel Edward De La Garza, LMT

Massage Therapist · Melbourne, FL

NPI number1861685273
StatusActive
Last updated in NPPESAug 20, 2007

Details

NPI
1861685273
Entity type
Individual (NPI-1)
Name
Mr. Daniel Edward De La Garza
Credential
LMT
Sex
Male
Sole proprietor
Yes
Enumeration date
Aug 20, 2007
Last updated
Aug 20, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225700000X Massage TherapistMA 47051FLYes

Other names

  • Danny Edward De La Garza (Other Name)

Practice location

6300 N Wickham Rd
Melbourne, FL 32940-2028

Phone 321-536-2173

Mailing address

4872 Outlook Dr
Melbourne, FL 32940-2334

Phone 321-536-2173

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