| NPI | 1053707224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLENE RUSSELL Director 228-283-5083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MS 35) |
| Additional Taxonomies | 172M00000X Mechanotherapist |
| 225700000X Massage Therapist | |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2016-02-05 |