Individual
MS. THEA ROCHELLE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT,
Contact information
Practice address
206 KUYRKENDALL PL, LONG BEACH, MS 39560-3308
(228) 323-1113
Mailing address
206 KUYRKENDALL PL, LONG BEACH, MS 39560-3308
(228) 323-1113
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT 1654
MS
Other
Enumeration date
04/28/2010
Last updated
04/28/2010
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