Individual
MS. KATHY A. RIEDERICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
501 ENGLE DR, TUCKER, GA 30084-2018
(404) 273-0616
Mailing address
501 ENGLE DR, TUCKER, GA 30084-2018
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT002646
GA
Other
Enumeration date
09/10/2010
Last updated
09/10/2010
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