Individual
DREXYL EITNIEAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6530 ANCHOR LOOP, APT. 18-207, BRADENTON, FL 34212
(786) 461-0271
Mailing address
6530 ANCHOR LOOP, APT. 18-207, BRADENTON, FL 34212
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MSG011919
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275081648
—
PA
Enumeration date
02/17/2019
Last updated
02/17/2019
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