Organization
MESA BODY THERAPY, LLC
Active
Other names
Mesa Body Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
TAWNEE BENNER LMT (MEMBER)
(573) 489-6383
Entity
Organization
Contact information
Practice address
97 PIKE ST, ROCHEPORT, MO 65279-9392
(573) 489-6383
Mailing address
PO BOX 45, ROCHEPORT, MO 65279-0045
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
05/22/2020
Last updated
05/22/2020
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