Individual
MIGUEL LUIS AYALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
105 N MAIN ST, HINESVILLE, GA 31313-3237
(912) 408-7777
Mailing address
1746 ASHTON DR, HINESVILLE, GA 31313-9110
(912) 492-7673
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT005482
GA
Other
Enumeration date
03/30/2011
Last updated
03/30/2011
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