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Individual

MR. DARRYL WAYNE DODD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT, NRTP

Contact information

Practice address
2441 JAMES ST STE 5C, CORALVILLE, IA 52241-1286
(319) 621-8184
Mailing address
725 TIMBER RIDGE CT, TIFFIN, IA 52340-4716
(319) 621-8184

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
079084
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
079084
LICENSED MASSAGE THERAPIST
IA
Enumeration date
06/08/2018
Last updated
06/08/2018
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