Individual
MR. DANIEL MALACHITE MEREWETHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2266 COBB CREEK DR, DECATUR, GA 30032-6175
(727) 385-6679
Mailing address
2266 COBB CREEK DR, DECATUR, GA 30032-6175
(727) 385-6679
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT012554
GA
Other
Enumeration date
11/17/2020
Last updated
11/17/2020
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