| NPI | 1659756633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JEROME WILLIAMS Licensed Massage Therapist 314-898-5218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO MT.0010974) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MO 000331) |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2015-07-20 |