Individual
MICHAEL JOHN NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
505 SPOKANE AVE, WHITEFISH, MT 59937-2780
(406) 862-1071
Mailing address
505 SPOKANE AVE, WHITEFISH, MT 59937-2780
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT-LMT-LIC-15833
MT
Other
Enumeration date
06/28/2019
Last updated
06/28/2019
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