Individual
MRS. BONITA ANN MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST MT
Contact information
Practice address
235 RUBY DR., CREATIVE MOVEMENT WORKSHOP, MACON, GA 31208
(478) 755-8844
(478) 746-7217
Mailing address
P.O. BOX 13412, 235 RUBY DR. CREATIVE MOVEMENT WORKSHOP, MACON, GA 31208
(478) 755-8844
(478) 746-7217
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT001093
GA
Other
Enumeration date
10/17/2008
Last updated
10/17/2008
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