Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225700000X | Massage Therapist | 000174 | CT |
NPI | 1003142910 |
---|---|
Provider Name | Mrs. Shannon Michele Kuzel |
First Address | Mansfield Center, CT 06250-1441 |
Second Address | Mansfield Center, CT 06250-1441 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2009 |
Last Update Date | 28/10/2009 |