Organization
MDJ MASSAGE LLC
Active
Organization
MDJ MASSAGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYELLYN NORIEGA LMT NCTMB (OWNER/LICENSED MASSAGE THERAPIST)
(229) 262-8008
Entity
Organization
Contact information
Practice address
4017 GREY OAK DR, VALDOSTA, GA 31605-5865
(229) 262-8008
(229) 232-4743
Mailing address
4017 GREY OAK DR, VALDOSTA, GA 31605-5865
(229) 262-8008
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
07/05/2020
Last updated
08/06/2020
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