Individual
LISA S WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
653 GRAND AVE, SAINT PAUL, MN 55105-3401
(651) 222-8517
Mailing address
4508 30TH AVE S, MINNEAPOLIS, MN 55406-3733
(612) 721-2135
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20030004142
MN
Other
Enumeration date
01/11/2007
Last updated
07/08/2007
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