NPI 1255168209

Chan Park

Practitioner Massage Therapist Ellicott City, MD

Practice location

Address: 10314b Baltimore National Pike, Ellicott City, MD 21042-2128
Phone: (410) 720-2464
Mailing address: 4703 Hallowed Strm, Ellicott City, MD 21042-5964

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence M06572 (MD)

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Registry record

NPI: 1255168209
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Sep 2024
Record last updated: 16 Sep 2024

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.