Individual
DIONNE M LACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
270 CARPENTER DR STE 500, ATLANTA, GA 30328-4946
(678) 408-0753
Mailing address
5505 FALLING WATER TER, ROSWELL, GA 30076-8831
(404) 822-3674
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT011017
GA
Other
Enumeration date
07/01/2017
Last updated
07/01/2017
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