Organization
MEDICAL MASSAGE OF DELAWARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE STAKER (LMT)
(888) 757-1951
Entity
Organization
Contact information
Practice address
105 MEGAN DR, BEAR, DE 19701-2085
(888) 757-1951
Mailing address
PO BOX 240, KIRKWOOD, DE 19708-0240
(888) 757-1951
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MT0001873
DE
Other
Enumeration date
09/22/2009
Last updated
09/22/2009
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