| NPI | 1104150358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM M EVANS Owner 925-689-8602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: CA Massage Therapist) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: CA 43135) |
| 133NN1002X Nutritionist, Nutrition, Education | |
| 207N00000X Dermatology (Licence: CA Z21679) | |
| Enumeration Date | 2009-09-21 |
| Last Update Date | 2020-07-10 |