Organization
GREENWAY MASSAGE TEAM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRRA GREEMWAY LMT, NCBTMB (OWNER)
(573) 449-4929
Entity
Organization
Contact information
Practice address
810 E WALNUT ST, COLUMBIA, MO 65201-4863
(573) 449-4929
(573) 449-4933
Mailing address
810 E WALNUT ST, COLUMBIA, MO 65201-4863
(573) 449-4929
(573) 449-4933
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
2006005578
MO
Other
Enumeration date
08/05/2007
Last updated
08/14/2007
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