Organization
THERAPEUTIC MASSAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY FERNLEY LMT (OWNER)
(760) 310-0530
Entity
Organization
Contact information
Practice address
3534 TEAYS VALLEY RD, HURRICANE, WV 25526-9054
(760) 310-0530
Mailing address
28 THOROUGHBRED RD, SCOTT DEPOT, WV 25560-9679
(760) 310-0530
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1999-0253
WV
Other
Enumeration date
08/15/2014
Last updated
08/15/2014
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