Individual
SHAMEKA GULLATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4749 NELSON BROGDON BLVD, BLD 100 SUITE 4, BUFORD, GA 30518-7513
(470) 769-0054
Mailing address
4749 NELSON BROGDON BLVD, BLD 100 SUITE 4, BUFORD, GA 30518-7513
(470) 769-0054
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
MT001306
GA
225700000X
Massage Therapist
Primary
MT001306
GA
Other
Enumeration date
03/15/2017
Last updated
03/15/2017
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