Individual
CHANDRA DAWN JUSTICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MMP
Contact information
Practice address
101 N KEMP AVE, TISHOMINGO, OK 73460-1719
(580) 371-7362
Mailing address
807 N BYRD ST, TISHOMINGO, OK 73460-1411
(580) 371-7362
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
157062
OK
Other
Enumeration date
07/31/2018
Last updated
07/31/2018
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