Individual
LAQUANA CRAWFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1689 PINE GLEN CIR, DECATUR, GA 30035-1534
(843) 879-1127
Mailing address
PO BOX 361957, DECATUR, GA 30036-1957
(843) 879-1127
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT011248
GA
Other
Enumeration date
12/08/2020
Last updated
09/10/2021
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