Organization
MASSAGE BY RAVEN (MOBILE, CLINICAL, MASSAGE)
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAVEN WALKER MT (LICENSED MASSAGE THERAPIST/OWNER)
(757) 453-5513
Entity
Organization
Contact information
Practice address
732 EDEN WAY NORTH SUITE E, CHESAPEAKE, VA 23320-2798
(757) 453-5513
Mailing address
732 EDEN WAY N STE E, CHESAPEAKE, VA 23320-2798
(757) 453-5513
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0019011535
CLINICAL MASSAGE THERAPIST
VA
05
—
0019011535
—
VA
Enumeration date
02/10/2022
Last updated
02/10/2022
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