Individual
STACEY LYN MADDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMBT
Contact information
Practice address
806 S SALISBURY GQ AVE, SALISBURY, NC 28146-8157
(704) 838-6165
Mailing address
947 N SALISBURY GQ AVE, SALISBURY, NC 28146-6817
(704) 838-6165
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
17380
NC
Other
Enumeration date
10/09/2019
Last updated
10/09/2019
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