MR. BO GONG
Massage Therapist
Active
Individual
NPI: 1407115835
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Massage Therapist | 225700000X | Yes | MA68483 (FL) |
| Student in an Organized Health Care Education/Training Program | 390200000X | No | MA68483 (FL) |
Frequently Asked Questions
NPI 1407115835 is the National Provider Identifier for MR. BO GONG, a Massage Therapist provider located in Melbourne, FL. This NPI was enumerated on May 4, 2012.
MR. BO GONG practices at 6559 N WICKHAM RD # C-103, Melbourne, FL 32940.
Quick Facts
- NPI
- 1407115835
- Type
- Individual
- Enumerated
- May 4, 2012
- Last Updated
- Feb 4, 2025
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