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General NPI Number Information
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NPI Number | 1962895755
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Entity Type | Individual
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Provider Name | JAMES CHARLES FITE LMT
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Gender | Male
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Dates
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Enumeration Date | 03/18/2015
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Last Update Date | 03/18/2015
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Provider Practice Location Address
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Address Line | 536 PEARL ST SUITE A
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City | BOWLING GREEN
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State | OH
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Zip | 43402-2730
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Country | US
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Telephone | 419-352-8946
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Fax | 419-352-8947
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Provider Business Mailing Address
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Address Line | 536 PEARL ST SUITE A
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City | BOWLING GREEN
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State | OH
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Zip | 43402-2730
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Country | US
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Telephone |
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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 | 305790
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License Number State | OH
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