Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 165484 | KY |
NPI | 1013458603 |
---|---|
Provider Name | Deborah Neff |
First Address | Bowling Green, KY 42102-2050 |
Second Address | Bowling Green, KY 42101-1703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2017 |
Last Update Date | 15/03/2017 |