Individual
LUANNE HETRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
96 LAKESHORE DR STE B, SAINT MARYS, GA 31558-3858
(912) 510-9355
Mailing address
119 S ARTHURS CT, KINGSLAND, GA 31548-4131
(912) 674-0883
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
MA72015
FL
225700000X
Massage Therapist
Primary
MT009260
GA
Other
Enumeration date
01/06/2015
Last updated
01/06/2015
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