Individual
ERICA SUZANNE INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4055 HOGAN DR, TYLER, TX 75709-6930
(903) 526-4744
Mailing address
1909 SHILOH RD APT 1, TYLER, TX 75703-2628
(903) 312-4644
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT125649
TX
Other
Enumeration date
04/11/2018
Last updated
04/11/2018
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