MEDICARE: JAMES BRADLEY TOON LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MA52310	FL

General Provider Information

NPI Number	:	1750933529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES BRADLEY TOON LMT

Provider Business Mailing Address
First Line	:	4063 LAURELWOOD DR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32257-8928
Country	:	US
Telephone Number	:	904-718-2942
Fax Number	:

Provider Business Practice Location Address
First Line	:	12443 SAN JOSE BLVD STE 801
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-8654
Country	:	US
Telephone Number	:	904-718-2942
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2019
Last Update Date	:	07/11/2019

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