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Individual

SHAWAN LATRELL MAYBANK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MASSAGE THERAPIST

Contact information

Practice address
709 INTERNATIONAL DR, CHARLOTTE, NC 28270-6973
(980) 202-1238
Mailing address
740 GATES MILLS DR, FORT MILL, SC 29708-7609
(704) 658-7205

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
13630
NC

Other

Enumeration date
07/15/2022
Last updated
07/15/2022
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