Individual
MRS. LAREINA M VIDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
1247 TEMPLE RD, POTTSTOWN, PA 19465-7362
(610) 952-1485
Mailing address
1247 TEMPLE RD, POTTSTOWN, PA 19465-7362
(610) 952-1485
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MSG007653
PA
Other
Enumeration date
10/11/2016
Last updated
10/11/2016
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