Individual
ANA MARIA VIDARTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
8400 HOLCOMB BRIDGE RD, ALPHARETTA, GA 30022-1837
(678) 777-7586
Mailing address
2855 CRYSTAL BROOKE LN, SNELLVILLE, GA 30078-4549
(678) 777-7586
(770) 982-2844
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
MT006953
GA
2251E1200X
Ergonomics Physical Therapist
MT006953
GA
225400000X
Rehabilitation Practitioner
MT006953
GA
225700000X
Massage Therapist
Primary
MT006953
GA
Other
Enumeration date
05/17/2011
Last updated
05/17/2011
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