Individual
CHARLES PHOENIX III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14030 ABERCORN ST, SAVANNAH, GA 31419-1935
(912) 712-2152
Mailing address
3123 CHASE ST, TOLEDO, OH 43611-3204
(567) 702-1151
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
33.026595
OH
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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