Individual
STACEY RICHELLE CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
32 MARKET PLACE, BIG SKY, MT 59716
(406) 995-7575
Mailing address
3230 S 26TH AVE, BOZEMAN, MT 59718-7434
(406) 570-8118
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
664
MT
Other
Enumeration date
08/31/2017
Last updated
08/31/2017
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