NPI 1427344811

Jewel Lannetta Mynahan, MT

Practitioner Massage Therapist Scarborough, ME

Practice location

Address: 632 US Route 1, Scarborough, ME 04074
Phone: (207) 883-1003

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence MT4162 (ME)

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Registry record

NPI: 1427344811
Entity type: Individual
Sex (as registered): Female
NPI issued: 23 Jun 2011
Record last updated: 23 Jun 2011

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.