Individual
TANESHA ANNE WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4470 W SUNSET BLVD # 92947, LOS ANGELES, CA 90027-6302
(657) 549-2836
Mailing address
4470 W SUNSET BLVD # 92947, LOS ANGELES, CA 90027-6302
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
76037
CA
Other
Enumeration date
09/25/2020
Last updated
09/25/2020
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