Individual
BROOKE THERIAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1585 S PLAZA WAY STE 150, FLAGSTAFF, AZ 86001-7156
(928) 226-1556
Mailing address
8025 N US HIGHWAY 89 LOT 3, FLAGSTAFF, AZ 86004-1209
(928) 593-0423
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-24171
AZ
Other
Enumeration date
11/30/2020
Last updated
11/30/2020
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