Chandra Dawn Justice
Massage Therapist
101 N Kemp Ave
Tishomingo
, Oklahoma 73460-1719
Chandra Dawn Justice
Massage Therapist
101 N Kemp Ave
Tishomingo
, Oklahoma 73460-1719
(580) 371-7362
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About
Features
Specialties
- Massage Therapist
Languages spoken
- English
Location
First Address
- Chandra Dawn Justice
- 807 N Byrd St
- Tishomingo, OK
- Zip : 73460-1411
- Phone : (580) 371-7362
Second Address
- Chandra Dawn Justice
- 101 N Kemp Ave
- Tishomingo, OK
- Zip : 73460-1719
- Phone : (580) 371-7362
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 157062 | OK |
National Provider Identifier
| NPI | 1003394263 |
|---|---|
| Provider Name | Chandra Dawn Justice |
| First Address | Tishomingo, OK 73460-1411 |
| Second Address | Tishomingo, OK 73460-1719 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 31/07/2018 |
| Last Update Date | 31/07/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.