Individual
SERITA BOSTICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4605 PEMBROKE LAKE CIR STE 303, VIRGINIA BEACH, VA 23455-6448
(757) 449-0178
Mailing address
3300 GWIN ST, PORTSMOUTH, VA 23704-6019
(757) 449-0178
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019010291
VA
Other
Enumeration date
11/17/2020
Last updated
01/02/2023
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