Individual
EDIE MERCADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
1202 US HIGHWAY 80, TYBEE ISLAND, GA 31328-9772
(912) 786-6063
Mailing address
PO BOX 6545, SAVANNAH, GA 31414-6545
(912) 224-8525
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT002160
GA
Other
Enumeration date
02/19/2008
Last updated
02/19/2008
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