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Individual

MS. LAURIE SHAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT, MMP

Contact information

Practice address
3085 LINE ST, SUMTER, SC 29153-8107
(940) 923-4813
Mailing address
3085 LINE ST, SUMTER, SC 29153-8107
(940) 923-4813

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7570
SC

Other

Enumeration date
10/23/2013
Last updated
10/23/2013
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