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Individual

CHARLES VICKREY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
2801 GREAT NORTHERN LOOP, MISSOULA, MT 59808-1745
(406) 549-9100
Mailing address
2224 RATTLESNAKE DRIVE., MISSOULA, MT 59802
(970) 599-6665

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
6031
MT

Other

Enumeration date
02/05/2014
Last updated
02/05/2014
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