Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 33.019085 | OH |
NPI | 1003188541 |
---|---|
Provider Name | Ms. Elaine Faye Merx |
First Address | Genoa, OH 43430-1113 |
Second Address | Bowling Green, OH 43402-2975 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2012 |
Last Update Date | 13/04/2015 |