Individual
TINA WHITEHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
112 WILLOW RD, STARKVILLE, MS 39759-3637
(662) 769-1143
Mailing address
110 LYNN LN APT 17B, STARKVILLE, MS 39759-3979
(662) 769-1143
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2732
MS
Other
Enumeration date
05/06/2020
Last updated
10/06/2024
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