Individual
JEREMY M DELLOSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
8200 E JACQUE DR, PRESCOTT VALLEY, AZ 86314-6172
(928) 277-8715
Mailing address
6279 N MOONLIGHT WAY, PRESCOTT VALLEY, AZ 86314-3352
(602) 733-3743
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-16774
AZ
Other
Enumeration date
12/03/2020
Last updated
12/03/2020
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