Individual
ASHLEY MICHELLE SOUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
141 SAMS ST STE A, DECATUR, GA 30030-4101
(404) 296-8511
Mailing address
3222 VICKERY DR SE, MARIETTA, GA 30066-4810
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
MT005132
GA
225X00000X
Occupational Therapist
Primary
OT006119
GA
Other
Enumeration date
05/26/2010
Last updated
12/06/2022
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