Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225700000X | Massage Therapist | 227.015879 | IL |
Y | 225700000X | Massage Therapist | MT122732 | TX |
NPI | 1003271511 |
---|---|
Provider Name | Thomeisha Carter |
First Address | Wichita Falls, TX 76308-4202 |
Second Address | Wichita Falls, TX 76308-4202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2015 |
Last Update Date | 28/12/2015 |