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Domanique Ingram
Massage Therapist in Longview, Texas
NPI 1205429180

Domanique Ingram is a Massage Therapist based in Longview, TX. Domanique Ingram practices in Longview, TX. The NPI Number for Domanique Ingram is 1205429180 and holds a License No. MT123998 (Texas).

The current practice location address for Domanique Ingram is 501 N Spur 63 Ste C1, Longview, TX and can be reached out via phone at 903-746-6019.

Location: 501 N Spur 63 Ste C1, Longview, TX, 75604-5844
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1205429180
Provider Name
Domanique Ingram
Credential
Provider Entity Type
Individual
Gender
Female
Address
501 N Spur 63 Ste C1, Longview, TX, 75604-5844
Phone Number
903-746-6019
Fax Number
Provider Enumeration Date
02/11/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
501 N Spur 63 Ste C1
City
Longview
State
Texas
Zip
75601-5010
Phone Number
903-746-6019
Fax Number
person
Provider Business Mailing Address Details
Address
501 N Spur 63 Ste C1
City
Longview
State
Texas
Zip
75601-5010
Phone Number
903-746-6019
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
MT123998 (Texas)
Definition
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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