Individual
TINA KEY RAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLC
Contact information
Practice address
903 S BROADWAY AVE, POTEAU, OK 74953-5217
(918) 429-8093
Mailing address
903 S BROADWAY AVE, POTEAU, OK 74953-5217
(918) 429-8093
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
191225
OK
Other
Enumeration date
08/23/2023
Last updated
08/23/2023
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