Individual
MRS. SHANNON LEE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT4652
Contact information
Practice address
5752 HIGHWAY 72, KILLEN, AL 35645-8242
(256) 272-1895
Mailing address
3740 HIGHWAY 101, ROGERSVILLE, AL 35652-2601
(256) 702-4213
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
4652
AL
Other
Enumeration date
05/05/2020
Last updated
05/05/2020
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