Individual provider · Type 1 NPI

Mark Edward Vennerholm Ii, CMT

Massage Therapist · Vista, CA

NPI number 1053012443 Active

Practice location

2305 S Melrose Dr Ste 103
Vista, CA 92081-8789

Call (760) 230-3898 Map

Mailing address

208 B Ave Apt A
Coronado, CA 92118-1998

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X93040 (CA)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1053012443

Mark Edward Vennerholm Ii, CMT's National Provider Identifier is 1053012443, issued on Mar 13, 2023. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Vista, CA. The record was last updated on Mar 13, 2023.