Individual
MRS. DOROTHY MONGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
123 ELM AVE, EATON, CO 80615-3425
(970) 454-2224
(970) 454-3147
Mailing address
123 ELM AVE, EATON, CO 80615-3425
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
819
CO
Other
Enumeration date
04/26/2011
Last updated
04/26/2011
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