Individual
TIMOTHY DWYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
534 BERNARD ST APT A, COSTA MESA, CA 92627-8541
(494) 388-9099
Mailing address
534 BERNARD ST APT A, COSTA MESA, CA 92627-8541
(494) 388-9099
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
73385
CA
Other
Enumeration date
09/14/2020
Last updated
09/14/2020
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