Individual
NICCOL R WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
19817 N 46TH DR, GLENDALE, AZ 85308-7325
(602) 367-2167
Mailing address
19817 N 46TH DR, GLENDALE, AZ 85308-7325
(602) 367-2167
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT17847
AZ
Other
Enumeration date
08/28/2013
Last updated
08/20/2019
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