Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 29190 | CA |
NPI | 1013279033 |
---|---|
Provider Name | Margaret Sparacin |
First Address | La Jolla, CA 92037-8039 |
Second Address | La Jolla, CA 92037-4720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2012 |
Last Update Date | 14/06/2012 |