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Individual

CARISA CHREE KING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MASSAGE THERAPIST

Contact information

Practice address
2141 KINGSTON CT SE STE 111, MARIETTA, GA 30067-8928
(470) 999-0392
Mailing address
2141 KINGSTON CT SE STE 111, MARIETTA, GA 30067-8928
(470) 999-0392

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT011526
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
052887721
MASSAGE THERAPIST
GA
Enumeration date
11/11/2020
Last updated
11/11/2020
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