Individual
ANDERSON DAVID THEODORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
5412 ROCK LAKE DR, ATLANTA, GA 30349-8905
(678) 644-7357
Mailing address
5412 ROCK LAKE DR, COLLEGE PARK, GA 30349-8905
(678) 644-7357
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT006637
GA
Other
Enumeration date
12/02/2025
Last updated
12/02/2025
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