Individual
TRACI LEVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1020 BRIDGE RD, CHARLESTON, WV 25314-1306
(304) 663-7488
Mailing address
808 VOGEL DR, CHARLESTON, WV 25302-2420
(304) 663-7488
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2007-2310
WV
Other
Enumeration date
02/08/2021
Last updated
02/08/2021
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