Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 2004-1570 | WV |
NPI | 1003937038 |
---|---|
Provider Name | Daniel B. Rich |
First Address | Beallsville, OH 43716 |
Second Address | Parkersburg, WV 26101-5339 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 08/07/2007 |