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Individual

KATHRINE A DORTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
KATHRINE DORTA

Contact information

Practice address
3444 CLUB DR, LAWRENCEVILLE, GA 30044-2402
(770) 330-7975
Mailing address
106 DAVIS MILL CT, LAWRENCEVILLE, GA 30044-4635
(770) 330-7975

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT003005
GA

Other

Enumeration date
09/08/2009
Last updated
09/08/2009
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