Individual
ELIZABETH SOUTHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2855 HORSESHOE PIKE, CAMPBELLTOWN, PA 17010
(717) 838-2600
Mailing address
27 N WASHINGTON ST, CLEONA, PA 17042-2341
(717) 838-2600
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MSG002743
PA
Other
Enumeration date
03/26/2015
Last updated
03/26/2015
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