Shera Elice McNeely, LMT

Individual provider Active NPI Massage Therapist · Gladewater, TX

NPI 1518257526 · NPPES record last updated Apr 11, 2011

Key facts

NPI
1518257526
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
LMT#111762 (TX)
Practice address
500 Allison St
Suite a
Gladewater, TX 75647-2214
Phone
(903) 720-8934
NPI assigned
Apr 11, 2011
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LMT#111762TXMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X LMT#111762 TX Yes

Addresses

Primary practice location

500 Allison St
Suite a
Gladewater, TX 75647-2214

Mailing address

500 Allison St
Suite a
Gladewater, TX 75647-2214
Phone (903) 720-8934

Other providers in Gladewater, TX

All providers in Gladewater, TX · Massage Therapist in Texas

Sources for this page

Verify at the official NPI Registry.