Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MT1382 | DC |
NPI | 1013440338 |
---|---|
Provider Name | Mr. Donald Eugene Norwood JR. |
First Address | Washington, DC 20009-2181 |
Second Address | Washington, DC 20009-2181 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2017 |
Last Update Date | 04/04/2017 |