Jeremiah Lyles Johnson, LMP Valid NPI

Individual provider · Massage Therapist · Marysville, WA

NPI

1467754986

Type

Individual (Type 1)

Primary specialty

Massage Therapist

Specialty group

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy code

225700000X

License number

MA60177126 (WA)

Sex

Male

Sole proprietor

No

Enumerated

2010-12-03

Last updated

2010-12-03