NPI 1003394263

Chandra Dawn Justice, MMP

Practitioner Massage Therapist Tishomingo, OK

Practice location

Address: 101 N Kemp Ave, Tishomingo, OK 73460-1719
Phone: (580) 371-7362
Mailing address: 807 N Byrd St, Tishomingo, OK 73460-1411

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 157062 (OK)

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Registry record

NPI: 1003394263
Entity type: Individual
Sex (as registered): Female
NPI issued: 31 Jul 2018
Record last updated: 31 Jul 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.