Individual provider · Type 1 NPI

Shaka D. McCormick, LMT

Massage Therapist · St. Louis, MO

NPI number 1083253520 Active

Practice location

2804 Osage St
St. Louis, MO 63118-4537

Call (314) 448-0143 Map

Mailing address

PO Box 27041
St. Louis, MO 63118-0041

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X2019000899 (MO)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1083253520

Shaka D. McCormick, LMT's National Provider Identifier is 1083253520, issued on Jan 1, 2020. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in St. Louis, MO. The record was last updated on Jan 1, 2020.