Individual
JUDITH CISCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3939 VAN HORN RD, TRENTON, MI 48183-4013
(734) 365-7101
Mailing address
3939 VAN HORN RD, TRENTON, MI 48183-4013
(734) 365-7101
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501000806
MI
Other
Enumeration date
05/14/2015
Last updated
05/14/2015
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