Individual
KETURAH DANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2481 PAULDING ST NW, KENNESAW, GA 30144-5647
(404) 512-9382
Mailing address
2481 PAULDING ST NW, KENNESAW, GA 30144-5647
(404) 512-9382
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT002243
GA
Other
Enumeration date
03/01/2012
Last updated
03/01/2012
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