Individual
AMANDA J CANTERBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
23297 HIGHWAY 53, GULFPORT, MS 39503-8227
(228) 261-9266
Mailing address
23297 HIGHWAY 53, GULFPORT, MS 39503-8227
(228) 261-9266
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1943
MS
Other
Enumeration date
06/07/2012
Last updated
06/07/2012
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