Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 013029 | OH |
NPI | 1003240946 |
---|---|
Provider Name | Kara Mccreary |
First Address | Orrville, OH 44667-1368 |
Second Address | Orrville, OH 44667-1368 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2013 |
Last Update Date | 28/08/2013 |