Individual
AMANDA M VIKDAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
10440 BUTTE DR, LONGMONT, CO 80504-6453
(907) 306-3433
Mailing address
10440 BUTTE DR, LONGMONT, CO 80504-6453
(907) 306-3433
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0024489
CO
Other
Enumeration date
10/30/2021
Last updated
10/30/2021
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