Individual
AMY M OW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
350 E 17TH ST, SUITE #111, COSTA MESA, CA 92627-3231
(831) 373-1403
Mailing address
PO BOX 772, PEBBLE BEACH, CA 93953-0772
(831) 373-1403
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14693
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/21/2008
Last updated
05/16/2012
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