Individual
BRONSON HARLEY DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1025 BROADWAY, SANTA CRUZ, CA 95062-2403
(916) 342-5248
Mailing address
1025 BROADWAY, SANTA CRUZ, CA 95062-2403
(916) 342-5248
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
90329
CA
Other
Enumeration date
09/05/2022
Last updated
09/05/2022
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