Individual
MRS. JAN LEE BIVINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
322 N TEXAS AVE STE 2, ODESSA, TX 79761-5184
(432) 352-4570
Mailing address
5514 W MILES ST, ODESSA, TX 79763-9000
(432) 352-4570
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT027544
TX
Other
Enumeration date
09/09/2013
Last updated
09/09/2013
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