Individual
LISA MARIE WOURMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1121 WESTRAC DR S STE 102, FARGO, ND 58103-2385
(701) 297-8191
Mailing address
1403 3RD AVE N, MOORHEAD, MN 56560-2238
(320) 760-4342
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1144
ND
Other
Enumeration date
12/07/2010
Last updated
12/04/2012
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