Individual
MS. LA SHAN BRIDGET ETTRESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
1660 NEIGHBORHOOD WALK, MCDONOUGH, GA 30252-8645
(323) 835-7306
Mailing address
100 POSTMASTER DR UNIT 3082, MCDONOUGH, GA 30253-2832
(678) 719-9703
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT012485
GA
Other
Enumeration date
09/03/2020
Last updated
02/04/2022
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