Shallon Andrea Church, L.M.T., R.C.R
Individual provider Active NPI Massage Therapist · Talbott, TN
NPI 1720499155 · NPPES record last updated May 20, 2014
Key facts
- NPI
- 1720499155
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 3283 (TN)
- Practice address
- 1171 East Highway 11-E
Suite 102
Talbott, TN 37877 - Phone
- (423) 737-8020
- NPI assigned
- May 20, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3283 | TN | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 3283 | TN | Yes |
Addresses
Primary practice location
1171 East Highway 11-E
Suite 102
Talbott, TN 37877
Mailing address
1171 East Highway 11-E
Suite 103
Talbott, TN 37877
Phone (423) 737-8020
Other providers in Talbott, TN
- Claudia Guadalupe Chavez
- Katie Izabella Cheek
- Cherokee Health Systems
- Cherokee Health Systems
- Chiropractic Center, P.C.
- Stephen L Clarke
- Mickie Cody
- Kenny Richard Cogburn
- Regina Nepomuceno Coleman
- Karen Keeter Collins
All providers in Talbott, TN · Massage Therapist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.