Individual
GABRIELLE FOUNTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
680 CRANE CREEK DR APT 427, AUGUSTA, GA 30907-3091
(850) 450-8156
Mailing address
680 CRANE CREEK DR APT 427, AUGUSTA, GA 30907-3091
(850) 450-8156
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT014891
GA
Other
Enumeration date
02/19/2024
Last updated
02/24/2024
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