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1740879147
LARISSA L HEAD
PORTAGE, MI
NPI
1740879147
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: MI 7501001123)
Enumeration Date
2021-01-12
Last Update Date
2021-01-12
Business Address
LARISSA L HEAD
4659 BLACKBURN AVE
PORTAGE, MI 49024-3045
Phone number: 989-327-7920
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Mailing Address
LARISSA L HEAD
4659 BLACKBURN AVE
PORTAGE, MI 49024-3045
Phone number: 989-327-7920
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