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Individual

ANN HAZEL TERRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT, LR

Contact information

Practice address
2600 52ND AVE S STE 103, C/O URBAN EDGE, FARGO, ND 58104-7173
(701) 566-2708
Mailing address
2600 52ND AVE S STE 103, FARGO, ND 58104-7173
(701) 566-2708

Taxonomy

Speciality
Code
Description
License number
State
173C00000X
Reflexologist
RB12199
ND
225700000X
Massage Therapist
Primary
1355
ND

Other

Enumeration date
02/06/2013
Last updated
02/06/2013
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