Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 33012061 | OH |
NPI | 1023132065 |
---|---|
Provider Name | David G Marlowe JR. |
First Address | Brecksville, OH 44141-2160 |
Second Address | Northfield, OH 44067-2054 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2007 |
Last Update Date | 08/07/2007 |