Individual
GENEVA STACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MMT
Contact information
Practice address
521 W KINGSHIGHWAY, PARAGOULD, AR 72450-4234
(870) 239-0368
Mailing address
521 W KINGSHIGHWAY, PARAGOULD, AR 72450-4234
(870) 239-0368
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2591
AR
Other
Enumeration date
05/23/2019
Last updated
05/23/2019
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