Organization
SWEETWATER LIFE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEKEISHA MARQUIS JONES LMT (OWNER)
(404) 734-8853
Entity
Organization
Contact information
Practice address
1117 MCGILL PARK AVE NE, ATLANTA, GA 30312-4221
(404) 734-8853
Mailing address
1117 MCGILL PARK AVE NE, ATLANTA, GA 30312-4221
(404) 734-8853
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
MT008978
GA
225700000X
Massage Therapist
Primary
MT008978
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT008978
MASSAGE THERAPY
GA
Enumeration date
08/18/2017
Last updated
07/21/2022
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