Individual
KSENIA FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
306 9TH AVE N APT 5, MYRTLE BEACH, SC 29577-3715
(843) 360-6469
Mailing address
306 9TH AVE N APT 5, MYRTLE BEACH, SC 29577-3715
(843) 360-6469
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12436
SC
Other
Enumeration date
06/28/2022
Last updated
06/28/2022
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