| NPI | 1528505302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY JEAN BELK Owner/Operator 190-965-2147 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CA 20000023557) |
| Additional Taxonomies | 225700000X Massage Therapist |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2017-04-28 |