Individual
BRIAN ENVER ALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
27 LAUREL RIDGE LANE, JASPER, GA 30143-5104
(404) 449-6561
Mailing address
11278 BIG CANOE, BIG CANOE, GA 30143-5104
(404) 449-6561
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT008084
GA
Other
Enumeration date
09/04/2020
Last updated
09/04/2020
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