Individual
JESIKA RIAN LA RUSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1801 MCCORD WAY APT 1246, FRISCO, TX 75033-1200
(682) 300-1565
Mailing address
1801 MCCORD WAY APT 1246, FRISCO, TX 75033-1200
(682) 300-1565
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT105628
TX
Other
Enumeration date
09/28/2020
Last updated
09/28/2020
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