Malissa M Bordelon, LMT

NPI #1619264157 in Long Beach, Mississippi

Provider Information

NPI Number: 1619264157
Entity Type: Individual
Name: Malissa M Bordelon, LMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: LMT
Enumeration Date: Jul 5, 2011
Last Updated: Jul 5, 2011

Practice Location

Address: 7198 BEATLINE RD
Address 2: SUITE A
City: Long Beach
State: Mississippi
ZIP Code: 39560-9146
Phone: (228) 868-9799

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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