Organization
MASSAGE HEIGHTS SHOAL CREEK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM DUSTERHOFT (OWNER)
(816) 792-4783
Entity
Organization
Contact information
Practice address
9225 NE 152 HWY, LIBERTY, MO 64158
(816) 792-4783
(816) 792-4957
Mailing address
9225 NE 152 HWY, LIBERTY, MO 64158
(816) 792-4783
(816) 792-4957
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2007037586
MO
302R00000X
Health Maintenance Organization
2007037586
MO
Other
Enumeration date
07/19/2011
Last updated
09/28/2011
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