Individual
KRISTI SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
84 TINICA WAY, NEWNAN, GA 30263-4234
(706) 302-6990
Mailing address
84 TINICA WAY, NEWNAN, GA 30263-4234
(706) 302-6990
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT006646
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT006646
MASSAGE THERAPY LICENSE
GA
Enumeration date
04/24/2023
Last updated
04/24/2023
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