Individual
DAKETIA L THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
300 W WIEUCA RD NE, ATLANTA, GA 30342-3352
(678) 900-6604
Mailing address
300 W WIEUCA RD NE, ATLANTA, GA 30342-3352
(678) 900-6604
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
7501007926
MI
225700000X
Massage Therapist
Primary
MT007221
GA
Other
Enumeration date
11/27/2012
Last updated
03/23/2022
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