NPI 1083253520

Shaka D McCormick, LMT

Practitioner Massage Therapist Saint Louis, MO

Practice location

Address: 2804 Osage St, Saint Louis, MO 63118-4537
Phone: (314) 448-0143
Mailing address: PO Box 27041, Saint Louis, MO 63118-0041

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 2019000899 (MO)

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Registry record

NPI: 1083253520
Entity type: Individual
Sex (as registered): Female
NPI issued: 1 Jan 2020
Record last updated: 1 Jan 2020

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.