Individual
WILLIAM JACKSON BRIDGES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT,CNMT
Contact information
Practice address
2420 BEMISS RD STE B, VALDOSTA, GA 31602-4809
(229) 293-9511
(229) 293-9141
Mailing address
PO BOX 3864, VALDOSTA, GA 31604-3864
(229) 293-9511
(229) 293-9141
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT000268
GA
Other
Enumeration date
07/24/2009
Last updated
07/24/2009
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