Individual
NATHAN JEFFERY BOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
4015 N BLAIR AVE, ROYAL OAK, MI 48073-2709
(248) 385-2990
Mailing address
24644 HICKORY ST, DEARBORN, MI 48124-2421
(734) 748-2847
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501012012
MI
Other
Enumeration date
04/21/2021
Last updated
04/21/2021
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