Individual
SHALA DAWN SOURS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NCMT
Contact information
Practice address
514 28 1/4 RD, 1, GRAND JUNCTION, CO 81501-4961
(970) 242-8162
Mailing address
935 N 12TH ST, 5, GRAND JUNCTION, CO 81501-3165
(970) 623-1176
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
4319
CO
Other
Enumeration date
01/05/2011
Last updated
01/05/2011
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