Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 33.024658 | OH |
NPI | 1003440306 |
---|---|
Provider Name | Heather Renee Owens |
First Address | West Chester, OH 45069-3682 |
Second Address | West Chester, OH 45069-3682 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2020 |
Last Update Date | 25/02/2020 |