Provider Demographics
NPI:1225351224
Name:OVIAN, KAROLYN KRISTY (LMT)
Entity Type:Individual
Prefix:MS
First Name:KAROLYN
Middle Name:KRISTY
Last Name:OVIAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:KAROLYN
Other - Middle Name:
Other - Last Name:CANTIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2815 CORINTHIAN AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-4314
Mailing Address - Country:US
Mailing Address - Phone:904-228-8127
Mailing Address - Fax:
Practice Address - Street 1:5210 YACHT CLUB RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-8326
Practice Address - Country:US
Practice Address - Phone:904-228-8127
Practice Address - Fax:904-389-9993
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA40254225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist