Individual
KELISHA BURNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
319 W 3RD AVE, CORSICANA, TX 75110-4665
(903) 851-7703
Mailing address
PO BOX 1535, CORSICANA, TX 75151-1535
(903) 851-7703
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT136247
TX
Other
Enumeration date
07/05/2024
Last updated
07/05/2024
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