Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist |
NPI | 1013341551 |
---|---|
Provider Name | Mrs. Florinda Berglund |
First Address | San Jose, CA 95148-2083 |
Second Address | San Jose, CA 95148-2083 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2013 |
Last Update Date | 31/08/2013 |