Individual
SHANEQUA ISAAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
882 KRAFT ST STE E, CLARKSVILLE, TN 37040-3062
(662) 275-3588
Mailing address
1605 NEEDMORE RD APT 204, CLARKSVILLE, TN 37040-2228
(662) 275-3588
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14633
TN
Other
Enumeration date
07/01/2024
Last updated
07/08/2024
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