Individual
BRYAN SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1403 KRISTINA WAY, CHESAPEAKE, VA 23320-8917
(757) 814-5646
Mailing address
6068 FORESTTOWN DR, NORFOLK, VA 23502-4720
(757) 814-5646
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
02/05/2024
Last updated
02/05/2024
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