Individual
OTIS DONOVAN HERRING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3041 W 7TH ST APT 526, LOS ANGELES, CA 90005-4120
(404) 457-9557
Mailing address
3041 W 7TH ST APT 526, LOS ANGELES, CA 90005-4120
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
97114
CA
Other
Enumeration date
11/20/2024
Last updated
11/20/2024
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