Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 33.016949 | OH |
NPI | 1013531490 |
---|---|
Provider Name | Kristen Carter |
First Address | Blanchester, OH 45107-9401 |
Second Address | Cincinnati, OH 45249-1600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2020 |
Last Update Date | 10/06/2020 |