Individual
MRS. JUTAMAS FACKLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1590 WILLOW CREEK RD, PRESCOTT, AZ 86301-1164
(928) 227-1899
Mailing address
2325 W BARD RANCH RD, PRESCOTT, AZ 86305-7769
(626) 422-3137
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-28340
AZ
Other
Enumeration date
07/13/2023
Last updated
07/13/2023
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