Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 31845 | CA |
NPI | 1013275015 |
---|---|
Provider Name | Betsy Heintz |
First Address | San Diego, CA 92117-6646 |
Second Address | San Diego, CA 92117-6646 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2012 |
Last Update Date | 26/04/2012 |