Individual
MRS. LACANA N TENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MLT
Contact information
Practice address
106 NEW HOPE RD, FAYETTEVILLE, GA 30214-1360
(678) 521-6434
Mailing address
569 KIMBERWICK DR, HAMPTON, GA 30228-3412
(678) 521-6434
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT008312
GA
Other
Enumeration date
09/06/2019
Last updated
09/06/2019
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