Individual
JACOB VAN NORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1625 HARRISON AVE, BUTTE, MT 59701-5401
(406) 565-8443
Mailing address
1625 HARRISON AVE, BUTTE, MT 59701-5401
(406) 565-8443
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT-LMT-LIC-9839
MT
Other
Enumeration date
03/11/2017
Last updated
03/11/2017
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