Individual
TRACI ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
217B S PRUETT ST, PARAGOULD, AR 72450-4331
(870) 215-2904
Mailing address
217B S PRUETT ST, PARAGOULD, AR 72450-4331
(870) 215-2904
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
9204
AR
Other
Enumeration date
09/11/2023
Last updated
09/11/2023
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