Individual
MRS. HOLLY DEEN DEROSSETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
2420 BEMISS RD., SUITE B, VALDOSTA, GA 31602
(229) 293-9511
Mailing address
2420 BEMISS RD., SUITE B, VALDOSTA, GA 31602
(229) 293-9511
(229) 293-9141
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT005886
GA
Other
Enumeration date
09/06/2013
Last updated
09/06/2013
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