Individual
HEATHER RENEE BLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
3100 WILDFLOWER DR, SUITE 611, BRYAN, TX 77802-3062
(979) 774-4343
Mailing address
3100 WILDFLOWER DR STE 611, BRYAN, TX 77802-3062
(979) 774-4343
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT114612
TX
Other
Enumeration date
04/18/2012
Last updated
04/18/2012
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