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Individual

MISS KALA EVANS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
1075 PEACHTREE ST NE UNIT 3118, ATLANTA, GA 30309-3912
(770) 765-1076
Mailing address
PO BOX 12187, ATLANTA, GA 30355-2187
(404) 642-5090

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT008487
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1588910145
GA
Enumeration date
07/31/2012
Last updated
03/12/2021
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