Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 5347 | SC |
NPI | 1013235076 |
---|---|
Provider Name | Allison Griffith |
First Address | North Charleston, SC 29420-8973 |
Second Address | Charleston, SC 29407-5768 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2010 |
Last Update Date | 13/05/2010 |