Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist |
NPI | 1013256841 |
---|---|
Provider Name | Alexandra Legowsky |
First Address | Troy, MI 48085-1291 |
Second Address | Troy, MI 48085-1291 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2013 |
Last Update Date | 14/02/2013 |