Individual
JACQUELINE THERESE KEENUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2554 HARRISON PIKE, CHATTANOOGA, TN 37406-1422
(423) 227-9474
Mailing address
2554 HARRISON PIKE, CHATTANOOGA, TN 37406-1422
(423) 227-9474
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT0000006538
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT 0000006538
TENNESSEE MASSAGE THERAPY BOARD
TN
Enumeration date
06/20/2008
Last updated
09/18/2012
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