Individual
ADDA ABBOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
215 SHADOWBROOKE CIR, LOGANVILLE, GA 30052-8247
(678) 516-1929
Mailing address
215 SHADOWBROOKE CIR, LOGANVILLE, GA 30052-8247
(678) 516-1929
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT005829
GA
Other
Enumeration date
07/21/2011
Last updated
07/22/2011
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