Most Relevant Information
Provider Data
| NPI Number: | 1003537069 |
| Provider Name: | MIRANDA BLAIR |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/08/2022 |
| Last Updated: | 09/08/2022 |
Provider Practice Location
15574 EDGEWOOD DR
BAXTER
MN
564016955
Practice Location Phone/Fax
| Phone: | 2188292665 |
| Fax: |
Provider Mailing Location
15574 EDGEWOOD DR
BAXTER
MN
564016955
Provider Mailing Phone/Fax
| Phone: | 2188292665 |
| Fax: |