Individual
TANYA HAZELWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
804 CHESAPEAKE ST, RONCEVERTE, WV 24970-1426
(304) 647-0046
Mailing address
804 CHESAPEAKE ST, RONCEVERTE, WV 24970-1426
(304) 647-0046
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20102716
WV
Other
Enumeration date
07/05/2011
Last updated
07/05/2011
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