Individual
JESSICA MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
615 E GURLEY ST, SUITE C, PRESCOTT, AZ 86301-3248
(928) 460-2393
Mailing address
615 E GURLEY ST, SUITE C, PRESCOTT, AZ 86301-3248
(928) 460-2393
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-02795
AZ
Other
Enumeration date
10/22/2015
Last updated
10/22/2015
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