Individual
MRS. AMANDA TUCKER QUEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMBT
Contact information
Practice address
117 RENEE FORD RD, LOCUST, NC 28097
(704) 985-3325
Mailing address
21756 CREST GOLD DR, LOCUST, NC 28097
(704) 985-3325
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
9520
NC
Other
Enumeration date
07/19/2016
Last updated
05/02/2017
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