Individual
JOHANNAH MACBETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
251 WATERMAN ST, PROVIDENCE, RI 02906-5210
(401) 453-4263
Mailing address
251 WATERMAN ST, PROVIDENCE, RI 02906-5210
(401) 453-4263
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
02267
RI
Other
Enumeration date
03/24/2016
Last updated
03/24/2016
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