Organization
SOUTHEASTERN NEUROMUSCULAR MASSAGE THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH G. STEVENS (THERAPIST)
(912) 383-4934
Entity
Organization
Contact information
Practice address
112 MADISON AVE N, DOUGLAS, GA 31533-4604
(912) 383-4934
(912) 383-4934
Mailing address
112 N. MADISON AVE., DOUGLAS, GA 31533
(912) 383-4934
(912) 383-4934
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
GA
225700000X
Massage Therapist
Primary
MT003853
GA
Other
Enumeration date
08/15/2012
Last updated
09/03/2013
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