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Respiratory, Developmental, Rehabilitative and Restorative Service Providers Massage Therapist

Provider NPI: 1659683290

Provider Information:
Gender: F
Not Sole Proprietor

Practice Location:
Tel: 502-561-6431  Fax: --

Business Mailing Address:
Tel: 502-561-8010  Fax: --

NPI Information:
NPI: 1659683290
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y225700000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Massage Therapist

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 225700000X





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