Individual
TERA MACKINAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
250C TWIN DOLPHIN DR, REDWOOD CITY, CA 94065-1402
(650) 631-1500
Mailing address
250C TWIN DOLPHIN DR, REDWOOD CITY, CA 94065-1402
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
12/18/2009
Last updated
12/18/2009
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