Individual
TIANA LEE CORCUERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T
Contact information
Practice address
411 TRAFFIC WAY, SUITE B, ARROYO GRANDE, CA 93420-3362
(805) 710-2214
Mailing address
1461 HETRICK AVE, ARROYO GRANDE, CA 93420-5928
(805) 710-2214
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3280
CA
Other
Enumeration date
07/03/2013
Last updated
07/03/2013
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