Individual
IMMARI STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1020 BRADDOCK CIR, WOODSTOCK, GA 30189-2381
(517) 755-7760
Mailing address
1020 BRADDOCK CIR, WOODSTOCK, GA 30189-2381
(517) 755-7760
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT014074
GA
Other
Enumeration date
03/03/2023
Last updated
03/03/2023
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