NPI 1609480342 · live from the CMS NPI Registry
Tomsene Johnetta Blake
Massage Therapist in Bowie, MD. National Provider Identifier 1609480342, active.
NPI record
| NPI | 1609480342 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Massage Therapist 225700000X |
| Practice location | 12115 Sutton Ln, Bowie, MD 20720 |
| Practice phone | 202-528-3067 |
| Mailing address | Po Box 7465, Largo, MD 20792 |
| Enumerated | September 1, 2020 |
| Last updated | September 1, 2020 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist primary | 225700000X | M01119 (MD) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.