New River Mediccal Massage

NPI #1194105247 in Radford, Virginia

Provider Information

NPI Number: 1194105247
Entity Type: Organization
Organization Name: New River Mediccal Massage
Primary Specialty: Specialist
Enumeration Date: Jun 4, 2015
Last Updated: Jun 4, 2015

Practice Location

Address: 319 W MAIN ST
City: Radford
State: Virginia
ZIP Code: 24141-1586
Phone: (540) 633-3828

Authorized Official

Name: MR. ROBERT ERNEST WALLACE, MASSAGE THERAPIST
Title: OWNER/THERAPIST
Phone: (540) 633-3828

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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