| NPI | 1952664898 |
|---|---|
| Doing Business As | MYSTIC MYRTLES STUFF LLC MASSAGE |
| Entity Type | Organization |
| Authorized Contact | DANIEL JOHN MCINTYRE CFO 928-753-3148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: AZ mt04442p) |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2012-06-15 |