Individual
BRIAN ODELL LOVE-EL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
260 NORTHERN AVE APT 2I, AVONDALE ESTATES, GA 30002-1758
(478) 444-1043
(478) 444-1043
Mailing address
260 NORTHERN AVE APT 2I, AVONDALE ESTATES, GA 30002-1758
(478) 444-1043
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT009568
GA
Other
Enumeration date
11/27/2020
Last updated
11/27/2020
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