Individual
SUSAN POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
55 CLIFTON ST SE, ATLANTA, GA 30317-2012
(404) 222-0334
Mailing address
55 CLIFTON ST SE, ATLANTA, GA 30317-2012
(404) 222-0334
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT002531
GA
Other
Enumeration date
07/16/2024
Last updated
07/16/2024
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