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Individual

MR. SON THACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
1722 4TH ST NW, WASHINGTON, DC 20001-1912
(202) 352-0344
Mailing address
1722 4TH ST NW, WASHINGTON, DC 20001-1912
(202) 352-0344

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1914
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MT1714
LICENSED MASSAGE THERAPIST
DC
Enumeration date
11/01/2021
Last updated
11/01/2021
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