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TEARZA MANNEAH BLACKMAN LMT

>> Massage Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1811669310

Individual Registrant:
 TEARZA MANNEAH BLACKMAN LMT
Gender: F
Sole Proprietor

Location and contact information for practice:
709 6TH ST  KERSEY, CO 80644-9782 US
Tel: 907-795-8864  Fax: --

Contact information for business:
709 6TH ST  KERSEY, CO 80644-9782 US
Tel: 907-795-8864  Fax: --

Registration Information:
NPI: 1811669310
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225700000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Massage Therapist
CO0021737

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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