Individual
ANDREW BLAIR DACRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
3300 N E EXPY NE STE C, ATLANTA, GA 30341-3932
(770) 500-3848
(678) 868-1114
Mailing address
3629 LINECREST TRL, ELLENWOOD, GA 30294-1972
(770) 334-0818
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT006007
GA
Other
Enumeration date
03/08/2013
Last updated
03/08/2013
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