Individual
MRS. SANDRA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
417 MARKET ST, KINGSTON, PA 18704-5418
(570) 283-1011
Mailing address
417 MARKET ST, KINGSTON, PA 18704-5418
(570) 283-1011
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MSG001103
PA
Other
Enumeration date
02/20/2012
Last updated
02/20/2012
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