Individual
AIMEE THERAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT21204375
Contact information
Practice address
162 SAGAMORE PKWY W, WEST LAFAYETTE, IN 47906-1569
(765) 357-1855
Mailing address
162 SAGAMORE PKWY W, WEST LAFAYETTE, IN 47906-1569
(765) 357-1855
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT1204375
IN
Other
Enumeration date
05/21/2016
Last updated
05/21/2016
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