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Individual

LANDON ELIZABETH GIRVIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
915 LAKE PARK BLVD N, CAROLINA BCH, NC 28428-4851
(910) 448-4965
Mailing address
504 KEYS LN, CAROLINA BCH, NC 28428-4730
(808) 633-3943

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19361
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
19361
MASSAGE THERAPIST LICENSE
NC
Enumeration date
11/07/2022
Last updated
11/07/2022
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