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Individual

MEWW GOMEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMBT

Contact information

Practice address
5701 EXECUTIVE CENTER DR STE 350, CHARLOTTE, NC 28212-8847
(704) 323-6718
Mailing address
5701 EXECUTIVE CENTER DR STE 350, CHARLOTTE, NC 28212-8847
(704) 323-6718

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
0019008213
VA
225700000X
Massage Therapist
17657
NC
225700000X
Massage Therapist
Primary
249

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0019008213
VIRGINIA DEPARTMENT OF HEALTH PROFESSIONALS
VA
01
17657
NORTH CAROLINA BOARD OF MASSAGE AND BODYWORK THERAPY
NC
01
249
NORTH CAROLINA BOARD OF MASSAGE AND BODYWORK THERAPY ESTABLISHMENT LICENSE
NC
Enumeration date
04/28/2020
Last updated
11/08/2023
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