Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 040713 | TX |
NPI | 1013368620 |
---|---|
Provider Name | Sherri Drackley |
First Address | Nrh, TX 76180 |
Second Address | Bedford, TX 76021 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2016 |
Last Update Date | 24/06/2016 |