Individual
MR. NATHAN WAYNE BALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMBT
Contact information
Practice address
4709 RUSHING DR, WILMINGTON, NC 28409-8969
(910) 431-4774
Mailing address
4709 RUSHING DR, WILMINGTON, NC 28409-8969
(910) 431-4774
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
07269
NC
Other
Enumeration date
12/04/2009
Last updated
12/04/2009
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