Individual
SHANNA R SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1120 S. 11TH ST, PORT ARANSAS, TX 78373-1404
(361) 389-1562
Mailing address
PO BOX 1404, PORT ARANSAS, TX 78373-1404
(361) 389-1562
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT104660
TX
Other
Enumeration date
09/17/2009
Last updated
09/17/2009
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