Individual
TERI SHEPHERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
9536 LIMA RD, FORT WAYNE, IN 46818-9517
(260) 402-8748
Mailing address
9536 LIMA RD, FORT WAYNE, IN 46818-9517
(260) 402-8748
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT20902563
IN
Other
Enumeration date
02/02/2014
Last updated
05/13/2016
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