Individual
PHONAN J MATFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2691 E MAIN ST, BEXLEY, OH 43209-2535
(614) 420-6268
Mailing address
2691 E MAIN ST, BEXLEY, OH 43209-2535
(614) 420-6268
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
33.022855
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33.022855
MASSAGE LICENSE
OH
Enumeration date
03/17/2020
Last updated
03/17/2020
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