Individual provider · Type 1 NPI
Malissa M. Bordelon, LMT
Massage Therapist · Long Beach, MS
NPI number
1619264157
Active
Practice location
7198 Beatline Rd, Suite A
Long Beach, MS 39560-9146
Mailing address
PO Box 8864
Gulfport, MS 39506-8864
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist Primary | 225700000X | 1861 (MS) |
Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
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About NPI 1619264157
Malissa M. Bordelon, LMT's National Provider Identifier is 1619264157, issued on Jul 5, 2011. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Long Beach, MS. The record was last updated on Jul 5, 2011.