Individual
MS. SHANNON NICHOLE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3561 DREHER SHOALS RD, IRMO, SC 29063-9115
(803) 201-3437
Mailing address
3561 DREHER SHOALS RD, IRMO, SC 29063-9115
(803) 201-3437
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7713
SC
Other
Enumeration date
07/05/2022
Last updated
07/05/2022
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