Individual
SIMONA RAE WHILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
109 BUSHAWAY RD, SUITE 200, WAYZATA, MN 55391-1945
(612) 387-6044
Mailing address
3251 LOUISIANA AVE S, UNIT 307, ST LOUIS PARK, MN 55426-4263
(612) 387-6044
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2010-81
MN
Other
Enumeration date
10/31/2010
Last updated
10/31/2010
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