Individual
LISA CHRISTIANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
2830 WADLEY LN, DACULA, GA 30019-5059
(678) 548-1918
Mailing address
2830 WADLEY LN, DACULA, GA 30019-5059
(678) 548-1918
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT000135
GA
Other
Enumeration date
06/08/2016
Last updated
06/08/2016
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