Organization
MASSAGE EXPERIENCE OF GEORGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAY BLOUNT LNMT (OWNER)
(404) 226-3590
Entity
Organization
Contact information
Practice address
1874 PIEDMONT AVE NE, STE 480D, ATLANTA, GA 30324-4869
(404) 226-3590
Mailing address
1874 PIEDMONT AVE NE, STE 480D, ATLANTA, GA 30324-4869
(404) 226-3590
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
MT000031
GA
Other
Enumeration date
06/13/2012
Last updated
06/13/2012
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