Individual
CAROL ANN WALSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
956 HIGHLAND VIEW NE, ATLANTA, GA 30306-3833
(404) 326-8415
Mailing address
956 HIGHLAND VIEW NE, ATLANTA, GA 30306-3833
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
166711LGB
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
166711LGB
BUSINESS LICENSE
GA
Enumeration date
01/17/2019
Last updated
01/17/2019
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