| NPI | 1629209705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA LEE MOLE Massage Therapist 304-637-1820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: WV 2002-0948) |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2009-08-06 |