Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 6636 | MA |
NPI | 1003127804 |
---|---|
Provider Name | Kristin Hilt |
First Address | Burlington, MA 01803-3767 |
Second Address | Burlington, MA 01803-3767 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2010 |
Last Update Date | 25/06/2010 |