Individual
NICOLE ANNIELL SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
226 N BROADWAY AVE STE 6, SYLACAUGA, AL 35150-2526
(716) 563-8422
Mailing address
226 N BROADWAY AVE, SYLACAUGA, AL 35150-2526
(716) 563-8422
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5181
AL
Other
Enumeration date
01/15/2025
Last updated
01/15/2025
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