Individual
PHENICIA WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1203 US HIGHWAY 98 STE 1F, DAPHNE, AL 36526-4255
(251) 303-9039
Mailing address
1203 US HIGHWAY 98 STE 1F, DAPHNE, AL 36526-4255
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2713
AL
Other
Enumeration date
04/29/2020
Last updated
04/29/2020
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