Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MSG012921 | PA |
NPI | 1013599794 |
---|---|
Provider Name | James Jowers |
First Address | Pittsburgh, PA 15216-2622 |
Second Address | Pittsburgh, PA 15216-2622 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2021 |
Last Update Date | 22/04/2021 |