Individual
TANILLE MARIE SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
89 OLDE MAIN PLZ, SAINT ALBANS, WV 25177-2707
(304) 437-0690
Mailing address
2550 CONNER AVE, HURRICANE, WV 25526-1024
(304) 437-0690
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2015-3329
WV
Other
Enumeration date
04/28/2017
Last updated
03/18/2021
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