Larry Wayne Robertson, LICENSED MASSAGE

NPI #1720868581 in Longview, Texas

Provider Information

NPI Number: 1720868581
Entity Type: Individual
Name: Larry Wayne Robertson, LICENSED MASSAGE
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: LICENSED MASSAGE
Enumeration Date: Sep 29, 2023
Last Updated: Sep 29, 2023

Practice Location

Address: 116 E SOUTH ST
City: Longview
State: Texas
ZIP Code: 75601-7437
Phone: (903) 230-1911

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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