Individual
MELISSA WARDLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
211 N HIGGINS AVE STE 403, MISSOULA, MT 59802-4488
(808) 652-6501
Mailing address
832 LOCUST ST, MISSOULA, MT 59802-3720
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
LMT-MLT-LIC-6080
MT
225700000X
Massage Therapist
Primary
LMT-LMT-LIC-6080
MT
Other
Enumeration date
02/09/2010
Last updated
03/17/2018
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