Individual
CORWIN RANDOLPH SHIRLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
8060 PURCHASE PL NE UNIT 4, LELAND, NC 28451-0977
(910) 725-4325
Mailing address
8060 PURCHASE PL NE UNIT 4, LELAND, NC 28451-0977
(910) 233-9627
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19204
NC
Other
Enumeration date
11/20/2024
Last updated
11/20/2024
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