Individual
SHAWN MCCONATHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT CMT
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
MT009659
GA
225700000X
Massage Therapist
Primary
MAS 9765
SC
225700000X
Massage Therapist
MT009659
GA
Other
Enumeration date
05/30/2014
Last updated
09/26/2016
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