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Individual

SHANNON JENKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CMT

Contact information

Practice address
1307 JAMESTOWN RD, SUITE 103, WILLIAMSBURG, VA 23185
(757) 229-4161
(757) 564-0581
Mailing address
8357 CARTERS MILL RD, RICHMOND, VA 23231
(804) 591-5012

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019013639
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
350504530010
VA
Enumeration date
05/10/2017
Last updated
05/10/2017
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