Individual
JUAN SAMUEL TAVAREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1410 GLENWATER DR, CARY, NC 27519-8226
(919) 599-4295
Mailing address
1410 GLENWATER DR, CARY, NC 27519-8226
(919) 599-4295
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21368
NC
Other
Enumeration date
08/23/2024
Last updated
08/23/2024
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