Individual
WANDA NERENE HOLDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICENSE MASSAGE THER
Contact information
Practice address
322 W 7TH AVE, SUITE C, CORSICANA, TX 75110-6402
(903) 872-2756
Mailing address
2005 W COLLIN ST, CORSICANA, TX 75110-4242
(903) 874-1703
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT010527
TX
Other
Enumeration date
12/04/2009
Last updated
05/17/2011
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