Individual
MISS MARY IRENE GARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
960 ST RT 72 SOUTH, SABINA, OH 45169
(937) 302-6911
Mailing address
960 ST RT 72 SOUTH, SABINA, OH 45169
(937) 302-6911
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3313387
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000487064
ANTHEM BLUE CROSS
OH
01
—
20492745200
W C
OH
Enumeration date
12/06/2006
Last updated
07/08/2007
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