Organization
SCULPTURES BODY SPA
Active
Organization
SCULPTURES BODY SPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATASHA JEFFERSON DNP (NURSE PRACTITIONER)
(470) 277-3552
Entity
Organization
Contact information
Practice address
885 HIGHWAY 138 W, STOCKBRIDGE, GA 30281-4261
(470) 377-2552
Mailing address
885 HIGHWAY 138 W, STOCKBRIDGE, GA 30281-4261
(470) 377-2552
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/08/2018
Last updated
11/08/2018
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