Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 4941 | KY |
NPI | 1013362128 |
---|---|
Provider Name | Meghan Little |
First Address | Lexington, KY 40507-1640 |
Second Address | Lexington, KY 40507-1640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2016 |
Last Update Date | 26/04/2016 |