Individual
AMY LYN BOFENKAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AMY
Contact information
Practice address
517 BROOKRIDGE DR, WINSTON SALEM, NC 27103-6104
(336) 391-7276
Mailing address
517 BROOKRIDGE DR, WINSTON SALEM, NC 27103-6104
(336) 391-7276
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10625
NC
Other
Enumeration date
12/14/2019
Last updated
12/14/2019
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