Individual
LUIS LARREA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
3915 MARK LAKE RD, CUMMING, GA 30028-5946
(404) 421-7273
Mailing address
3915 MARK LAKE RD, CUMMING, GA 30028-5946
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT013302
GA
Other
Enumeration date
04/13/2026
Last updated
04/13/2026
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