Individual
JODI LYNN BURCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
201 W LAKEWAY RD STE 200, GILLETTE, WY 82718-6341
(307) 682-7885
Mailing address
3701 MIRANDA AVE, GILLETTE, WY 82718-5759
(307) 620-1176
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
12/13/2017
Last updated
12/13/2017
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