Individual
MR. HENRY MOON CLOUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
2204 DIXON AVE, MISSOULA, MT 59801-8224
(406) 239-4817
(406) 728-0978
Mailing address
1701 MIDDLE BURNT FORK RD, STEVENSVILLE, MT 59870-6649
(406) 239-4817
(406) 728-0978
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
01/09/2013
Last updated
01/09/2013
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