Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist |
NPI | 1003135773 |
---|---|
Provider Name | Virginia M Hayataka |
First Address | Belmont, MI 49306-8600 |
Second Address | Belmont, MI 49306-8600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2010 |
Last Update Date | 22/07/2010 |