Individual
MEESHA TAVARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
405 E OMAHA ST STE D, RAPID CITY, SD 57701-2974
(605) 348-2116
Mailing address
11641 ELLIOTT RD, CUSTER, SD 57730-8238
(208) 971-5356
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT11919
SD
Other
Enumeration date
07/19/2022
Last updated
07/19/2022
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