Individual
MR. CARL I VANLOO
Active
Individual
MR. CARL I VANLOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.M.P.
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00012365
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0194907
DEPT. OF L&I
WA
01
—
2158VA
REGENCE
WA
Enumeration date
03/09/2007
Last updated
07/08/2007
Update your record
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