Individual
JESSICA SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
105 CLAY CIR, DAPHNE, AL 36526-8126
(318) 277-7096
Mailing address
105 CLAY CIR, DAPHNE, AL 36526-8126
(318) 277-7096
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
6380
AL
Other
Enumeration date
12/27/2024
Last updated
12/27/2024
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