Individual
TABITHA LYNN NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.T
Contact information
Practice address
801 S COMMERCIAL ST, HARRISONVILLE, MO 64701-1603
(816) 884-0309
Mailing address
401 GALAXIE AVE, HARRISONVILLE, MO 64701-2078
(816) 884-0309
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2011004613
MO
Other
Enumeration date
06/08/2012
Last updated
06/20/2013
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