| NPI | 1437857679 |
|---|---|
| Doing Business As | MOUNTAIN STATE MEDICAL MASSAGE |
| Entity Type | Organization |
| Authorized Contact | JENNY NICKERSON Owner 720-841-1042 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist |
| Enumeration Date | 2023-02-17 |
| Last Update Date | 2023-09-06 |