Individual
MS. MUZIQUE LATISE BROADNAX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT, MMP,LMT,CA
Contact information
Practice address
2915 WAYZATA BLVD, 304, MINNEAPOLIS, MN 55405-2145
(612) 396-2016
Mailing address
4600 E WASHINGTON ST STE 300, PHOENIX, AZ 85034-1908
(612) 486-2775
Taxonomy
Speciality
Code
Description
License number
State
175L00000X
Homeopath
938479
MN
225700000X
Massage Therapist
Primary
MT-27885
AZ
Other
Enumeration date
11/16/2010
Last updated
09/29/2021
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