Individual
GEORGIA T BURBULIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
6667 VERNON WOODS DR STE B27, SANDY SPRINGS, GA 30328-3216
(770) 617-3446
Mailing address
704 WILLOWWIND DR, LOGANVILLE, GA 30052-6601
(770) 617-3446
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
011128
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011128
LICENSED MASSAGE THERAPIST
GA
Enumeration date
07/25/2016
Last updated
10/17/2019
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