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Tristan Luke Dancer, LMT

Massage Therapist in Jacksonville, FL. Individual provider (NPI-1).

NPI number1932004199
StatusActive
Last updated in NPPESOct 8, 2026

Details

NPI
1932004199
Entity type
Individual (NPI-1)
Name
Tristan Luke Dancer
Credential
LMT
Sex
Male
Sole proprietor
Yes
Enumeration date
Oct 8, 2026
Certification date
Oct 8, 2026
Last updated
Oct 8, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225700000X Massage TherapistMA109953FLYes

Practice location

4004 Shasta Ct
Jacksonville, FL 32207-5724

Phone 904-874-5369

Mailing address

4004 Shasta Ct
Jacksonville, FL 32207-5724

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