Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 19905 | NC |
NPI | 1003572397 |
---|---|
Provider Name | Mrs. Jewal Velore Knight |
First Address | Angier, NC 27501-8106 |
Second Address | Smithfield, NC 27577-9495 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2021 |
Last Update Date | 11/11/2021 |