NPI 1104169069

Leland Greer Whitehurst, LMTNCTMB

Practitioner Massage Therapist Fargo, ND

Practice location

Address: 1404 33rd St S #g, Fargo, ND 58103-3482
Phone: (701) 200-2712

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 1293 (ND)

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Registry record

NPI: 1104169069
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Mar 2013
Record last updated: 29 Mar 2013

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.