Individual
MS. STACY DIANE FORTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
2406 E HENNEPIN AVE, MINNEAPOLIS, MN 55413-2705
(612) 331-5700
Mailing address
2406 E HENNEPIN AVE, MINNEAPOLIS, MN 55413-2705
(612) 331-5700
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
N/A
MN
Other
Enumeration date
10/14/2011
Last updated
10/14/2011
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