Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 7501000660 | MI |
NPI | 1013473487 |
---|---|
Provider Name | Xin Zhong |
First Address | Rochester Hills, MI 48306-4237 |
Second Address | Rochester Hills, MI 48307-4472 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2019 |
Last Update Date | 11/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7501000660 | MASSAGE THERAPY (01) | MI |