Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 33.019653 | OH |
NPI | 1013283332 |
---|---|
Provider Name | Renee M Endres |
First Address | Bedford Heights, OH 44146-1790 |
Second Address | Bedford Heights, OH 44146-1790 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2012 |
Last Update Date | 30/03/2012 |