Individual
TYNA BOCCAROSSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
12412 CHANNELVIEW DR, NEWBURG, MD 20664-2212
(301) 536-3897
Mailing address
12412 CHANNELVIEW DR, NEWBURG, MD 20664-2212
(301) 536-3897
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
M01503
MD
Other
Enumeration date
02/10/2016
Last updated
02/10/2016
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