Individual
ASHLEY MICHELLE MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
9525 HILLWOOD DR STE 100, LAS VEGAS, NV 89134-0596
(702) 642-5446
Mailing address
649 LINESHACK LN, LAS VEGAS, NV 89110-2110
(702) 715-7112
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT014566
STATE LICENSE
GA
01
—
NVMT10083
STATE LICENSE
NV
Enumeration date
10/26/2020
Last updated
05/26/2023
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