Organization
MEDICAL MASSAGE OF COWETA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA TALLEY LMT, MMP (MEDICAL MASSAGE THERAPIST)
(678) 590-8040
Entity
Organization
Contact information
Practice address
3025B SHARPSBURG MCCULLUM RD STE 108, NEWNAN, GA 30265-6107
(678) 590-8040
(347) 823-8404
Mailing address
3025B HWY 154, SUITE 108, NEWNAN, GA 30265-6107
(678) 590-8040
(347) 823-8404
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT002072
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619176278
—
GA
Enumeration date
08/13/2018
Last updated
02/28/2025
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