MRS. Mary Victoria Jetmore-Reichardt, MP

NPI #1548565476 in Crestline, California

Provider Information

NPI Number: 1548565476
Entity Type: Individual
Name: MRS. Mary Victoria Jetmore-Reichardt, MP
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: MP
Enumeration Date: Jan 25, 2011
Last Updated: Jan 25, 2011

Practice Location

Address: 580 FOREST SHADE #4
City: Crestline
State: California
ZIP Code: 92325
Phone: (909) 338-6477

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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