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NPI 1740948686

NPI 1740948686 : CHARITY WHITING LMT : TUCSON, AZ

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General NPI Number Information
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    NPI Number           |    1740948686
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    Entity Type          |    Individual 
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    Provider Name        |    CHARITY WHITING LMT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/07/2021
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    Last Update Date     |    12/07/2021
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Provider Practice Location Address
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    Address Line         |    1222 E BROADWAY BLVD 
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    City                 |    TUCSON
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    State                |    AZ
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    Zip                  |    85719-5821
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    Country              |    US
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    Telephone            |    805-319-1550
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1250 E 10TH ST APT 105B 
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    City                 |    TUCSON
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    State                |    AZ
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    Zip                  |    85719-5801
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    Country              |    US
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    Telephone            |    805-319-1550
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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       |    18758
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    License Number State |    AZ
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