Individual
MARY TERESA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
158 S HOUSTON LAKE RD STE 3, WARNER ROBINS, GA 31088-8018
(478) 396-6658
Mailing address
107 STONEY CREEK DR, KATHLEEN, GA 31047-3119
(478) 396-6658
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT010968
GA
Other
Enumeration date
04/20/2018
Last updated
04/20/2018
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