Individual
BRUCE JARROD KANDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT, MP
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
21472
OR
225700000X
Massage Therapist
Primary
MA 60563683
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21472
MASSAGE THERAPIST
OR
01
—
MA60563683
MASSAGE THERAPIST
WA
Enumeration date
07/21/2015
Last updated
07/21/2015
Update your record
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