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1386043289
CHARLES D. AVERY
SUPERIOR, MT
NPI
1386043289
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: MT LMT-LMT-LIC6171)
Enumeration Date
2014-08-15
Last Update Date
2014-08-15
Business Address
Mr. CHARLES D. AVERY LMT
120 SECOND AVE E.
SUPERIOR, MT 59872
Phone number: 406-822-1040
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Mailing Address
Mr. CHARLES D. AVERY LMT
POST OFFICE BOX 784
SUPERIOR, MT 59872
Phone number: 406-822-1040
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