Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 8823 | OH |
NPI | 1013549609 |
---|---|
Provider Name | Cammy Rene' Decker |
First Address | Hot Springs National Park, AR 71913-8896 |
Second Address | Hot Springs National Park, AR 71901-5315 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2020 |
Last Update Date | 11/02/2020 |