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Individual
SHANNON THARP
Active
Individual
SHANNON THARP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT.
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
13036
OR
Other
Enumeration date
02/17/2012
Last updated
02/17/2012
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