Organization
MASSAGE ON DA GO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWANDA EUNICE CHANEY (OWNER)
(901) 591-6485
Entity
Organization
Contact information
Practice address
199 ROSEMARY DR APT 4, SOUTHAVEN, MS 38671-3977
(901) 591-6485
Mailing address
199 ROSEMARY DR APT 4, SOUTHAVEN, MS 38671-3977
(901) 591-6485
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2038
MS
Other
Enumeration date
07/29/2015
Last updated
07/29/2015
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