Most Relevant Information
Provider Data
| NPI Number: | 1003412792 |
| Provider Name: | KIERA DAWN SHEPHERD LMT |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | 16885 |
Most Important Dates
| Enumeration Date: | 12/08/2020 |
| Last Updated: | 12/08/2020 |
Provider Practice Location
503 W 26TH ST APT 6
SAN PEDRO
CA
907316399
Practice Location Phone/Fax
| Phone: | 5625331073 |
| Fax: |
Provider Mailing Location
503 W 26TH ST APT 6
SAN PEDRO
CA
907316399
Provider Mailing Phone/Fax
| Phone: | 5625331073 |
| Fax: |