Individual
JUSTIN VAN DUYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1310 N 2ND ST APT 2412, PHOENIX, AZ 85004-1778
(929) 303-4423
Mailing address
623 EAGLE ROCK AVE # 199, WEST ORANGE, NJ 07052-2948
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-29051
AZ
Other
Enumeration date
06/06/2023
Last updated
06/06/2023
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