Individual
ADANSEPIPIM OFORIATTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
20528 BOLAND FARM RD, GERMANTOWN, MD 20876-4021
(301) 916-0164
(240) 252-5824
Mailing address
8 AMARILLO CT, GERMANTOWN, MD 20874-6100
(240) 271-5890
(240) 252-5824
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
M04850
MD
Other
Enumeration date
02/06/2020
Last updated
02/06/2020
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