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Individual

ERIC STEPHEN BOOTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCMT

Contact information

Practice address
7761 PLANTATION RD, GLOUCESTER, VA 23061-3224
(804) 694-6575
Mailing address
7761 PLANTATION RD, GLOUCESTER, VA 23061-3224
(804) 694-6575

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019009871
VA

Other

Enumeration date
11/08/2016
Last updated
11/08/2016
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