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General NPI Number Information
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NPI Number | 1972061794
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Entity Type | Individual
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Provider Name | GUIJUN DU
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Gender | Female
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Dates
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Enumeration Date | 03/11/2019
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Last Update Date | 03/11/2019
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Provider Practice Location Address
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Address Line | 431 STACY RD STE 107
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City | FAIRVIEW
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State | TX
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Zip | 75069-8717
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Country | US
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Telephone | 972-332-8558
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Fax |
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Provider Business Mailing Address
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Address Line | 3228 PEACHTREE LN
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City | PLANO
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State | TX
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Zip | 75074-2947
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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 | MT130816
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License Number State | TX
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