Individual
MS. JACQUELINE ODESSA WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
109 LOWER HARMONY RD LOT 4, LOT # 4, EATONTON, GA 31024-6062
(706) 816-3499
Mailing address
109 LOWER HARMONY RD LOT 4, EATONTON, GA 31024-6062
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT009249
GA
Other
Enumeration date
09/26/2013
Last updated
09/26/2013
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