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Individual

DWAYNE PITTMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
C.M.T.

Contact information

Practice address
502 W OCEAN VIEW AVE, NORFOLK, VA 23503-1416
(757) 748-7763
Mailing address
502 W OCEAN VIEW AVE, NORFOLK, VA 23503-1416
(757) 748-7763

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
599621-10
VA

Other

Enumeration date
01/14/2011
Last updated
01/14/2011
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