Individual
JEANETTE LISA CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
100 S GAY ST, SUSANVILLE, CA 96130-4314
(925) 497-7391
Mailing address
100 S GAY ST, SUSANVILLE, CA 96130-4314
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
68913
CA
Other
Enumeration date
06/10/2017
Last updated
06/11/2019
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