Individual
LILY DUAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10900 MEDLOCK BRIDGE RD STE 101A, JOHNS CREEK, GA 30097-1505
(470) 628-4065
Mailing address
2831 WILLOWSTONE DR, DULUTH, GA 30096-4013
(718) 885-6880
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT009921
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT009921
MASSAGE THERAPIST
GA
Enumeration date
03/24/2022
Last updated
03/24/2022
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