Individual
GINA WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
159 ONETA ST STE 4, ATHENS, GA 30601-1804
(706) 207-4796
Mailing address
725 BEAVERDAM RD APT F, WINTERVILLE, GA 30683-3931
(706) 207-4796
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT013287
GA
Other
Enumeration date
03/17/2025
Last updated
03/17/2025
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