Individual
EDWARD SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MT
Contact information
Practice address
4051 CEDAR LN, PORTSMOUTH, VA 23703-2003
(757) 535-7234
Mailing address
4051 CEDAR LN, PORTSMOUTH, VA 23703-2003
(757) 535-7234
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019016284
VA
Other
Enumeration date
12/26/2019
Last updated
12/26/2019
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