NPI 1073111886

Jason Scully

Practitioner Massage Therapist Fairfield, CA

Practice location

Address: 871 Sunset CT, Fairfield, CA 94533-4145
Phone: (707) 971-6649

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 839445 (CA)

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Registry record

NPI: 1073111886
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Oct 2020
Record last updated: 14 Oct 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.