Individual
MISS TIARA Z LIBERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.M.T
Contact information
Practice address
1203 MOUNT AVE, MISSOULA, MT 59801-5601
(406) 543-5251
(406) 543-5251
Mailing address
1203 MOUNT AVE, MISSOULA, MT 59801
(406) 543-5251
(406) 543-5251
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1000319834121
MT
Other
Enumeration date
05/13/2009
Last updated
05/13/2009
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