Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 5660 | AL |
NPI | 1003491655 |
---|---|
Provider Name | Cheryl Robinson |
First Address | Montgomery, AL 36106-2651 |
Second Address | Montgomery, AL 36105-2332 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2021 |
Last Update Date | 16/03/2021 |