Organization
A NATURAL MASSAGE
Active
Organization
A NATURAL MASSAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK G ROGERSON NCTMB (OWNER)
(928) 505-8667
Entity
Organization
Contact information
Practice address
2178 MCCULLOCH BLVD N, SUITE 12, LAKE HAVASU CITY, AZ 86403-6864
(928) 505-8667
(928) 505-2300
Mailing address
2178 MCCULLOCH BLVD N, SUITE 12, LAKE HAVASU CITY, AZ 86403-6864
(928) 505-8667
(928) 505-2300
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
01531
AZ
Other
Enumeration date
06/30/2015
Last updated
06/30/2015
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