Individual
JUSTIN FARRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
405 ALBERTO WAY STE 1, LOS GATOS, CA 95032-5406
(408) 674-1316
Mailing address
1245 LAKESIDE DR APT 3011, SUNNYVALE, CA 94085-1005
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3654
CA
Other
Enumeration date
02/18/2014
Last updated
02/18/2014
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