GARY EDWARD BLACK

TUMWATER, WA
NPI1427452572
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225700000X Massage Therapist
(Licence: WA  MA 60326924)
Enumeration Date2014-10-17
Last Update Date2014-10-17
Business Address
GARY EDWARD BLACK LMP
205 CLARK PL SE
TUMWATER, WA 98501-4062
Phone number: 360-570-0401
Mailing Address
GARY EDWARD BLACK LMP
124 SILVERTHISTLE RD
WINLOCK, WA 98596-9731
Phone number: 360-304-9126
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