Individual
TAMMY RENEE SHACKELFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MMP
Contact information
Practice address
600 ENERGY CENTER BLVD. SUITE 1701, NORTHPORT, AL 35473
(205) 331-4342
Mailing address
600 ENERGY CENTER BLVD. SUITE 1701, NORTHPORT, AL 35473
(205) 331-4342
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5336
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTHER
OTHER
AL
Enumeration date
11/16/2022
Last updated
11/16/2022
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