Individual
JOHNTAE LANA BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
920 PAVERSTONE DR STE B, RALEIGH, NC 27615-4723
(919) 228-8501
Mailing address
5129 CHASTEAL TRL, RALEIGH, NC 27610-6421
(910) 859-0667
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
15949
NC
Other
Enumeration date
05/24/2024
Last updated
05/24/2024
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