Individual
LAURA ANN PRINCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
22 S PUBLIC SQ STE B, JEFFERSON, GA 30549-1502
(770) 547-4525
Mailing address
PO BOX 1136, JEFFERSON, GA 30549-0918
(770) 547-4525
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT006208
GA
Other
Enumeration date
01/06/2010
Last updated
01/06/2010
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