Individual
AUTUMN VERNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
101 WILSHIRE BLVD, SANTA MONICA, CA 90401-1106
(310) 319-3193
Mailing address
PO BOX 1873, SANTA MONICA, CA 90406-1873
(818) 398-2319
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
60894
CA
Other
Enumeration date
05/23/2024
Last updated
05/23/2024
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