Individual
TIMOTHY SHANE DUKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2900 S CONGRESS AVE STE 104, AUSTIN, TX 78704-6421
(512) 507-5672
Mailing address
9404 SAN DIEGO RD, AUSTIN, TX 78737-3034
(512) 587-2561
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT014995
TX
Other
Enumeration date
09/22/2020
Last updated
09/22/2020
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