Individual provider · NPI-1

Antione Gerald Council, MT

Massage Therapist · Pittsburgh, PA

NPI number1104535665
StatusActive
Last updated in NPPESNov 22, 2022

Details

NPI
1104535665
Entity type
Individual (NPI-1)
Name
Antione Gerald Council
Credential
MT
Sex
Male
Sole proprietor
Yes
Enumeration date
Nov 22, 2022
Certification date
Nov 22, 2022
Last updated
Nov 22, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225700000X Massage TherapistMSG014449PAYes

Practice location

2001 Perrysville Ave Apt 1
Pittsburgh, PA 15214-3613

Phone 412-680-6394

Mailing address

2001 Perrysville Ave Apt 1
Pittsburgh, PA 15214-3613

Phone 412-680-6394

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