Individual
JEANNE THOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
21150 N TATUM BLVD APT 1045, PHOENIX, AZ 85050-4296
(623) 262-8323
Mailing address
21150 N TATUM BLVD APT 1045, PHOENIX, AZ 85050-4296
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-17646
AZ
Other
Enumeration date
09/22/2020
Last updated
09/22/2020
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