Individual
MARISA VANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5936 BEARD AVE N, BROOKLYN CENTER, MN 55429-2630
(763) 402-1013
Mailing address
5936 BEARD AVE N, BROOKLYN CENTER, MN 55429-2630
(763) 402-1013
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
MN
Other
Enumeration date
12/27/2016
Last updated
12/27/2016
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