Individual
JUSTIN DANIEL BENNITTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
354 NEWNAN CROSSING BYP STE B, NEWNAN, GA 30265-2323
(470) 400-1980
Mailing address
1391 GORDON RD, MORELAND, GA 30259-2541
(931) 257-4760
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT011129
GA
Other
Enumeration date
11/03/2022
Last updated
11/03/2022
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