Individual
JASON SHIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1301 SCOTT ST, SUITE 11, LITTLE ROCK, AR 72202-5051
(501) 396-9184
Mailing address
923 W CHARLES BUSSEY AVE, LITTLE ROCK, AR 72206-1110
(501) 258-7763
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8452
AR
Other
Enumeration date
04/30/2017
Last updated
04/30/2017
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