Individual
ANTOINETTE MARIE POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
14615 INTERSTATE 35 N, LIVE OAK, TX 78233
(210) 902-9092
Mailing address
3712 MORRIS LYNN, SAN ANTONIO, TX 78261-2110
(210) 302-2456
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT116789
TX
Other
Enumeration date
10/18/2017
Last updated
10/18/2017
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