Individual
DADRA MAJOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4434 COLUMBIA RD, SUITE 107, MARTINEZ, GA 30907-4556
(706) 530-1619
Mailing address
2455 AMSTERDAM DRIVE, APT 2E, AUGUSTA, GA 30906
(706) 284-0946
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT009885
GA
Other
Enumeration date
02/01/2017
Last updated
02/01/2017
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