Individual
MS. TAMECA LAZELL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, MMP
Contact information
Practice address
220 LANIER AVE E, FAYETTEVILLE, GA 30214-1604
(404) 452-9326
Mailing address
215 PEBBLESTUMP PT, PEACHTREE CITY, GA 30269-1619
(404) 452-9326
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT003393
GA
Other
Enumeration date
11/06/2008
Last updated
09/17/2014
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