| NPI | 1750424743 |
|---|---|
| Former Name | LAURA MARGARET DODGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA00017097) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 10058) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2007-07-08 |