Phyllis Douglass, CAMTC# 56843

NPI #1447852017 in Glendora, California

Provider Information

NPI Number: 1447852017
Entity Type: Individual
Name: Phyllis Douglass, CAMTC# 56843
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: CAMTC# 56843
Enumeration Date: Nov 10, 2020
Last Updated: Nov 10, 2020

Practice Location

Address: 340 S GLENDORA AVE
City: Glendora
State: California
ZIP Code: 91741-6255
Phone: (909) 967-0246

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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