Individual
DIANA PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCTMB
Contact information
Practice address
4225 THOMAS AVE N, MINNEAPOLIS, MN 55412-1519
(612) 414-5857
Mailing address
4225 THOMAS AVE N, MINNEAPOLIS, MN 55412-1519
(612) 414-5857
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
141044-00
GA
Other
Enumeration date
02/18/2015
Last updated
02/18/2015
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