Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 2008-2524 | WV |
NPI | 1013159375 |
---|---|
Provider Name | Ms. Tina M Turner |
First Address | Huntington, WV 25704-0514 |
Second Address | Huntington, WV 25705-2070 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2009 |
Last Update Date | 17/03/2018 |