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General NPI Number Information
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NPI Number | 1669231841
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Entity Type | Individual
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Provider Name | ANNETTE BIZZELL LMT
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Gender | Female
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Dates
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Enumeration Date | 03/18/2024
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 1210 SE MAYNARD RD
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City | CARY
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State | NC
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Zip | 27511-6943
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Country | US
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Telephone | 919-889-1242
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Fax |
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Provider Business Mailing Address
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Address Line | 4711 HOPE VALLEY ROAD 4F 306
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City | DURHAM
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State | NC
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Zip | 27707
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Country | US
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Telephone | 919-889-1242
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 11901
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License Number State | NC
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