Individual
DWAYNE FIRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CMT
Contact information
Practice address
734 GREEN TREE CIR, APT 203, CHESAPEAKE, VA 23320-3788
(757) 376-0471
Mailing address
734 GREEN TREE CIRCLE, APT 203, CHESAPEAKE, VA 23320-3789
(757) 376-0471
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019004740
VA
Other
Enumeration date
05/10/2017
Last updated
05/10/2017
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