Individual
JOSIAN C BANSRUPAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
50 NEWARK PL, BELLEVILLE, NJ 07109-1916
(202) 241-8250
Mailing address
50 NEWARK PL, BELLEVILLE, NJ 07109-1916
(201) 241-8250
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18KT00725400
NJ
Other
Enumeration date
09/14/2020
Last updated
09/14/2020
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