Dallas Bryant, LMT
Massage Therapist in Mount Laurel, NJ. Individual provider (NPI-1).
NPI number1396136388
StatusActive
Last updated in NPPESFeb 11, 2015
Details
- NPI
- 1396136388
- Entity type
- Individual (NPI-1)
- Name
- Dallas Bryant
- Credential
- LMT
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 11, 2015
- Last updated
- Feb 11, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | 18kt00436200 | NJ | Yes |
Practice location
813 E Gate Dr Ste BMount Laurel, NJ 08054-1238
Phone 215-873-1168
Mailing address
207 Nathaniel AveCherry Hill, NJ 08003-1528
Phone 215-873-1168
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