Individual
TIFFANY EDNA CROFT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
309 PIRKLE FERRY RD STE A200, CUMMING, GA 30040-2546
(470) 839-5867
Mailing address
405 HEARD DR, DAWSONVILLE, GA 30534-6746
(706) 265-0124
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT003275
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1065920
ASHN
GA
Enumeration date
07/29/2006
Last updated
01/14/2019
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