Individual
MINDY LU IVIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1282 RT 113, BLOOMING GLEN, PA 18911
(267) 424-3240
Mailing address
1282 RT 113 #126, BLOOMING GLEN, PA 18911
(267) 424-3240
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MSG007317
PA
Other
Enumeration date
01/04/2016
Last updated
01/04/2016
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