Individual
AGNES SHANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3 CORBETT WAY, EATONTOWN, NJ 07724-2283
(732) 500-3191
Mailing address
926 WOODMERE DR, KEYPORT, NJ 07735-5543
(732) 500-3191
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18KT00741200
NJ
Other
Enumeration date
07/08/2015
Last updated
07/08/2015
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