Individual
SHAKAYA MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1720 DUTCH FORK RD STE D, IRMO, SC 29063-8871
(803) 834-6112
Mailing address
509 HALLECK LN, COLUMBIA, SC 29229-8096
(803) 840-8031
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
13180
SC
Other
Enumeration date
08/29/2023
Last updated
08/29/2023
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