Organization
MIDLINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN K JOHNSON CMT, ROLFER (MANAGING MEMBER)
(831) 421-9222
Entity
Organization
Contact information
Practice address
555 SOQUEL AVE STE 350, SANTA CRUZ, CA 95062-2320
(831) 421-9222
(831) 421-9229
Mailing address
555 SOQUEL AVE STE 350, SANTA CRUZ, CA 95062-2320
(831) 421-9222
(831) 421-9229
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
ST. DOES NOT LICENSE
CA
Other
Enumeration date
08/24/2010
Last updated
08/24/2010
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