Individual
MRS. STAFONYA DESHEA CLARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4341 US ROUTE 60, SUITE127, HUNTINGTON, WV 25705-2942
(304) 840-1504
Mailing address
4341 US ROUTE 60, SUITE 127, HUNTINGTON, WV 25705-2942
(304) 840-1504
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2005-1924
WV
Other
Enumeration date
11/13/2007
Last updated
04/12/2013
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