Individual
TERA LYNN BRAXTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4513 OLD SHELL RD, MOBILE, AL 36608-1922
(251) 650-2424
Mailing address
4513 OLD SHELL RD, MOBILE, AL 36608-1922
(251) 650-2424
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3071
AL
Other
Enumeration date
06/17/2020
Last updated
06/17/2020
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