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1306004965
MIMI M FOUNTAIN
DURANGO, CO
NPI
1306004965
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: IL 441885-00)
Enumeration Date
2008-05-29
Last Update Date
2008-05-30
Business Address
Mrs. MIMI M FOUNTAIN NCBTMB, RN
1005 WATERFALL LN
DURANGO, CO 81301-3741
Phone number: 970-759-8872
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Mailing Address
Mrs. MIMI M FOUNTAIN NCBTMB, RN
1005 WATERFALL LN
DURANGO, CO 81301-3741
Phone number: 970-759-8872
Copy
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