Individual
RANDALL SCOTT WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMBT
Contact information
Practice address
4732 LEBANON RD STE D, MINT HILL, NC 28227-9112
(704) 763-2059
Mailing address
4732 LEBANON RD STE D, MINT HILL, NC 28227-9112
(704) 763-2059
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
08381
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08381
NORTH CAROLINA BOARD OF MASSAGE & BODYWORK THERAPY
NC
Enumeration date
01/23/2020
Last updated
01/30/2020
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