Individual
MELISSA J GAMBRILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
114 12TH ST W STE F, TIFTON, GA 31794-6976
(229) 402-7833
Mailing address
114 12TH ST W STE F, TIFTON, GA 31794-6976
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT014009
GA
225700000X
Massage Therapist
R02510
MD
Other
Enumeration date
08/17/2021
Last updated
02/22/2023
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