Organization
ISLAND THERAPEUTIC MASSAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA STOVALL (OWNER/OPERATOR)
(612) 735-0610
Entity
Organization
Contact information
Practice address
6043 HUDSON RD, SUITE 125, WOODBURY, MN 55125-1018
(612) 735-0610
Mailing address
6043 HUDSON RD, SUITE 125, WOODBURY, MN 55125-1018
(612) 735-0610
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
09/18/2012
Last updated
09/19/2012
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