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Individual

SIMON ISAAC DE LA ROSA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT/CMT

Contact information

Practice address
623 HEMISFAIR BLVD APT 611, SAN ANTONIO, TX 78205-3354
(210) 889-4635
Mailing address
623 HEMISFAIR BLVD APT 611, SAN ANTONIO, TX 78205-3354
(210) 889-4635

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
84708
CA
225700000X
Massage Therapist
Primary
MT130587
TX

Other

Enumeration date
06/28/2023
Last updated
06/28/2023
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