Individual
LISA M MIKELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
305 W MAIN ST, SWAINSBORO, GA 30401-3176
(478) 268-7129
Mailing address
305 W MAIN ST, SWAINSBORO, GA 30401-3176
(478) 269-7129
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT007403
GA
Other
Enumeration date
11/21/2025
Last updated
11/21/2025
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