Individual
TAMMIE EL-SHABAZZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
185 GLENGARY CT, FAYETTEVILLE, GA 30214-7379
(313) 574-1490
Mailing address
185 GLENGARY CT, FAYETTEVILLE, GA 30214-7379
(313) 574-1490
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT007284
GA
Other
Enumeration date
02/22/2011
Last updated
02/22/2011
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