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Individual

QUEENETTA JERNAINE RICHARDSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
3228 UNIVERSITY AVE STE 105-106, COLUMBUS, GA 31907-7209
(706) 992-6866
(706) 992-6867
Mailing address
3228 UNIVERSITY AVE STE 105-106, COLUMBUS, GA 31907-7209
(706) 992-6866
(706) 992-6867

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT006964
GA

Other

Enumeration date
02/06/2023
Last updated
02/06/2023
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