Organization
MISTY'S TANNING AND ULTIMATE SALON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MISTY BURKS (OWNER)
(406) 541-7500
Entity
Organization
Contact information
Practice address
3101 S RUSSELL ST, MISSOULA, MT 59801-6872
(406) 543-0717
Mailing address
PO BOX 1211, MISSOULA, MT 59806-1211
(406) 543-0717
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
12/08/2011
Last updated
12/08/2011
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