NPI 1295341261

Stanford David Joseph, CMT

Practitioner Massage Therapist Fairfield, CA

Practice location

Address: 1068 Peppertree Dr, Fairfield, CA 94533-8108
Phone: (707) 430-6048

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 24248 (CA)

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Registry record

NPI: 1295341261
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Sep 2020
Record last updated: 16 Sep 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.