Individual
CHARISSE C CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
685 PROVIDENCE MAIN ST NW APT 333, HUNTSVILLE, AL 35806-2661
(757) 284-0059
(254) 613-9071
Mailing address
685 PROVIDENCE MAIN ST NW APT 333, HUNTSVILLE, AL 35806-2661
(757) 284-0059
(254) 613-9071
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
M128304
TX
Other
Enumeration date
01/22/2019
Last updated
05/11/2022
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