Individual
MRS. JENNIFER L VANDERBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
240 N. HIGGINS #11, MISSOULA, MT 59802
(406) 529-1958
Mailing address
PO BOX 111, DIXON, MT 59831
(406) 529-1958
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
LMT-LMT-LIC-675
MT
Other
Enumeration date
08/28/2012
Last updated
08/28/2012
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