Individual
TANESHA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1043 NEILL DR, COLUMBUS, GA 31904-7127
(706) 330-4856
Mailing address
1817 TRADITION WAY, PHENIX CITY, AL 36867-3842
(706) 330-4856
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT015679
GA
Other
Enumeration date
01/13/2026
Last updated
01/13/2026
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