Jennifer Tietsort

NPI #1528442316 in Custer, South Dakota

Provider Information

NPI Number: 1528442316
Entity Type: Individual
Name: Jennifer Tietsort
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Enumeration Date: Jul 12, 2015
Last Updated: Jul 12, 2015

Practice Location

Address: 632 MOUNT RUSHMORE RD
City: Custer
State: South Dakota
ZIP Code: 57730-2031
Phone: (605) 440-0126

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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