Individual
MARY M LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
120 ELK AVE., CRESTED BUTTE, CO 81224
(970) 209-5984
Mailing address
PO BOX 786, CRESTED BUTTE, CO 81224-0786
(970) 209-5984
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
9832
CO
Other
Enumeration date
05/25/2012
Last updated
05/25/2012
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