Individual
TAMIKA DILLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
21449 BEAU CHATEAU BLVD, PONCHATOULA, LA 70454-5600
(985) 969-2739
Mailing address
21449 BEAU CHATEAU BLVD, PONCHATOULA, LA 70454-5600
(985) 969-2739
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
4569
LA
Other
Enumeration date
09/12/2016
Last updated
09/22/2016
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