Individual
JASON ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1621 W LAWRENCE DR, SCOTTSBURG, IN 47170-6808
(812) 595-9886
Mailing address
1621 W LAWRENCE DR, SCOTTSBURG, IN 47170-6808
(812) 595-9886
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT21907011
IN
Other
Enumeration date
09/30/2020
Last updated
09/30/2020
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