Individual
ELISA C CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
307 MAPLE AVE W STE L, VIENNA, VA 22180-4307
(703) 672-1613
Mailing address
307 MAPLE AVE W STE L, VIENNA, VA 22180-4307
(703) 672-1613
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019013040
VA
Other
Enumeration date
01/22/2019
Last updated
06/11/2019
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