Individual
SHANDRA STALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
124 CHESTNUT ST # 18, PHILADELPHIA, PA 19106-3009
(877) 797-5349
Mailing address
124 CHESTNUT ST # 18, PHILADELPHIA, PA 19106-3009
(877) 797-5349
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MSG002301
PA
Other
Enumeration date
01/05/2024
Last updated
01/05/2024
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