Individual
SHANNON MARIE WILLOUGHBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
211 HIGHWAY 17 N, NORTH MYRTLE BEACH, SC 29582-8107
(843) 489-0788
Mailing address
6703 JEFFERSON PL APT B7, MYRTLE BEACH, SC 29572-3708
(843) 232-6357
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3485
SC
225700000X
Massage Therapist
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—
Other
Enumeration date
02/15/2013
Last updated
05/12/2023
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