Individual
SUSAN ANNETTE OLIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
220 BROAD ST STE 203, KINGSPORT, TN 37660-4245
(423) 361-0545
Mailing address
195 WOODMONT AVE, KINGSPORT, TN 37660-3224
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10572
TN
Other
Enumeration date
02/26/2018
Last updated
02/26/2018
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