Individual
JOSEPH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
595 CASCADE AVE SW, ATLANTA, GA 30310-2407
(786) 468-6353
Mailing address
595 CASCADE AVE SW, ATLANTA, GA 30310-2407
(786) 468-6353
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
008912
GA
Other
Enumeration date
01/20/2023
Last updated
01/20/2023
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