Individual
BROCK MCCONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
444 HIGHLAND AVE NE, ATLANTA, GA 30312-1301
(678) 467-2704
Mailing address
3993 NORTHSTRAND DR, DECATUR, GA 30035-2369
(678) 467-2704
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
009732
GA
Other
Enumeration date
03/03/2023
Last updated
03/03/2023
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