Individual
SHERRY L GHAVASSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1138 HIGHWAY 77, SOUTHSIDE, AL 35907-0404
(256) 295-7705
Mailing address
1138 HIGHWAY 77, SOUTHSIDE, AL 35907-0404
(256) 295-7705
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
4692
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4692
MASSAGE THERAPIST
AL
Enumeration date
04/26/2019
Last updated
04/26/2019
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