Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 9575 | NC |
NPI | 1013211291 |
---|---|
Provider Name | Angela Rochner |
First Address | Mooresville, NC 28117-8402 |
Second Address | Mooresville, NC 28117-8402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2011 |
Last Update Date | 25/01/2011 |