Individual
JOSE JESUS VEGA III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1684 VILLAGE GRN, CROFTON, MD 21114-2059
(443) 938-1201
Mailing address
1684 VILLAGE GRN, CROFTON, MD 21114-2059
(443) 938-1201
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
M04706
MD
Other
Enumeration date
11/24/2014
Last updated
01/13/2015
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