Individual
JOE DAVID SECREST IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
5800 EDWARDS RANCH RD STE 200, FORT WORTH, TX 76109-4126
(843) 345-3271
Mailing address
5800 EDWARDS RANCH RD STE 200, FORT WORTH, TX 76109-4126
(843) 345-3271
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT120063
TX
Other
Enumeration date
11/08/2011
Last updated
12/31/2018
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