Individual
BRIAN DOUGLAS WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2045 ROCKBRIDGE RD, STONE MOUNTAIN, GA 30087-3551
(678) 883-2873
Mailing address
4018 SUE LN, DECATUR, GA 30035-1075
(404) 438-4477
(800) 975-1805
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT007445
GA
Other
Enumeration date
08/26/2015
Last updated
08/26/2015
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