Individual
LUCRETIA BENEE VINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2575 WHITEHAVEN DR SW STE 121, MARIETTA, GA 30064-4569
(675) 402-7243
Mailing address
3355 SLATE DR, AUSTELL, GA 30106-3185
(678) 402-7243
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT012340
GA
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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