Individual
TAMMY PACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
420 N COLUMBIA AVE, RINCON, GA 31326-6806
(912) 826-3624
Mailing address
PO BOX 2255, RINCON, GA 31326-2255
(912) 826-3624
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT009777
GA
246RP1900X
Phlebotomy Technician
—
—
Other
Enumeration date
08/26/2014
Last updated
06/19/2019
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