Individual
MRS. GWENDOLYN LAVONNE KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
512 HARROW RD, RICHMOND, VA 23225-4234
(410) 564-9898
Mailing address
512 HARROW RD, RICHMOND, VA 23225-4234
(410) 564-9898
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019009875
VA
Other
Enumeration date
10/06/2011
Last updated
10/06/2011
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