Individual
TANIKA ANNETTE GILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4 HAMPTON LN, JACKSON, TN 38305
(731) 616-7601
Mailing address
4 N HAMPTON LN, JACKSON, TN 38305-3924
(731) 616-7601
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
6375
TN
Other
Enumeration date
07/28/2017
Last updated
07/21/2022
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