Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | #MT00285P | AZ |
NPI | 1003985441 |
---|---|
Provider Name | Ms. Robin Byler Thomas |
First Address | Tucson, AZ 85745-9443 |
Second Address | Tucson, AZ 85745-9443 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 08/07/2007 |