Individual
MISS RACQUEL P BRAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT MMP
Contact information
Practice address
5840 ROSWELL RD, ATLANTA, GA 30328-4972
(470) 446-9501
Mailing address
PO BOX 13714, ATLANTA, GA 30324-0714
(470) 446-9501
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT011371
GA
Other
Enumeration date
10/03/2019
Last updated
10/03/2019
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