Individual
CHANTAL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
295 BROOKVIEW DR, RIVERDALE, GA 30274-7207
(678) 429-8094
Mailing address
295 BROOKVIEW DR, RIVERDALE, GA 30274-7207
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT010943
GA
Other
Enumeration date
09/16/2020
Last updated
09/16/2020
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