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1518664655
RICHARD DARYL SHACKLEFORD
JASPER, AL
NPI
1518664655
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: AL 2388)
Enumeration Date
2023-02-09
Last Update Date
2023-02-09
Business Address
RICHARD DARYL SHACKLEFORD LMT
409 10TH AVE
JASPER, AL 35501-3630
Phone number: 205-876-3177
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Mailing Address
RICHARD DARYL SHACKLEFORD LMT
4463 CUMBY RD
QUINTON, AL 35130-9196
Phone number: 205-876-3177
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