| NPI | 1548405806 |
|---|---|
| Former Name | JEANNIE S DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA 60425265) |
| Additional Taxonomies | 174400000X Specialist |
| 225700000X Massage Therapist (Licence: CO MT 0007629) | |
| Enumeration Date | 2008-12-15 |
| Last Update Date | 2014-01-14 |