Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225700000X | Massage Therapist | 13564 | OH |
NPI | 1003006909 |
---|---|
Provider Name | Julia Ann Pinkham |
First Address | Columbus, OH 43221-4076 |
Second Address | Columbus, OH 43221 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2007 |
Last Update Date | 25/06/2018 |