Individual
LUCIANO DIAZ-TAIROVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2 E BLACKWELL ST STE 15, DOVER, NJ 07801-4645
(908) 220-0732
(973) 361-1360
Mailing address
2 E BLACKWELL ST STE 15, DOVER, NJ 07801-4645
(908) 220-0732
(973) 361-1360
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18KT00638600
NJ
Other
Enumeration date
11/18/2017
Last updated
11/18/2017
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