Individual
MRS. SHAWN TAYLOR MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT, MMP, RYT-200
Contact information
Practice address
1720 DUTCH FORK RD STE D, IRMO, SC 29063-8871
(803) 261-2131
Mailing address
PO BOX 253, BALLENTINE, SC 29002-0253
(803) 261-2131
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8625
SC
Other
Enumeration date
07/11/2019
Last updated
07/11/2019
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