Organization
MOBILE MASSAGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM QUELL PATRICK JR. LMT (MASSAGE THERAPIST)
(240) 778-8187
Entity
Organization
Contact information
Practice address
307 MAPLE AVE W, VIENNA, VA 22180-4307
(240) 778-8187
Mailing address
307 MAPLE AVE W, VIENNA, VA 22180-4307
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
0019011159
VA
Other
Enumeration date
04/16/2014
Last updated
04/16/2014
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