Individual
MR. JASON FISKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
725 W ALDER ST, MISSOULA, MT 59802-4036
(406) 493-1115
Mailing address
1821 S 4TH ST W, MISSOULA, MT 59801-2229
(406) 240-4428
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT-LMT-LIC-21517
MT
Other
Enumeration date
01/18/2022
Last updated
01/18/2022
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