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Individual

DARRICK STEWART ROACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1225 MARSHALL ST., 18, CRESCENT CITY, CA 95531
(707) 954-8978
(707) 460-1401
Mailing address
1225 MARSHALL ST., 18, CRESCENT CITY, CA 95531
(707) 954-8978
(707) 460-1401

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
64848
CA

Other

Enumeration date
09/01/2016
Last updated
09/01/2016
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