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General NPI Number Information
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NPI Number | 1902490410
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Entity Type | Organization
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Legal Business Name | JOSHUA SHIPP, LLC
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Dates
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Enumeration Date | 02/24/2021
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Last Update Date | 02/24/2021
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Provider Practice Location Address
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Address Line | 1222 ATLANTIC AVE
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City | LONG BEACH
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State | CA
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Zip | 90813-3315
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Country | US
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Telephone | 314-706-1579
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Fax |
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Provider Business Mailing Address
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Address Line | 1222 ATLANTIC AVE
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City | LONG BEACH
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State | CA
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Zip | 90813-3315
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Country | US
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Telephone | 314-706-1579
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSHUA SHIPP
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Credential |
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Telephone | 314-706-1579
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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 |
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License Number State |
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