Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist |
NPI | 1013100254 |
---|---|
Provider Name | Geoffrey Lyn Steele |
First Address | Clarksburg, WV 26301-2310 |
Second Address | Clarksburg, WV 26301-2310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2007 |
Last Update Date | 21/08/2007 |