Individual
TIFFANY PAIGE PICKTHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
731 HASTINGS ST, MOUNT VERNON, MO 65712-1077
(417) 366-4654
Mailing address
731 HASTINGS ST, MOUNT VERNON, MO 65712-1077
(417) 366-4654
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2023009294
MO
Other
Enumeration date
07/08/2024
Last updated
07/08/2024
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