Individual
LELA LONGWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
466 N LEARD ST LOT 25, HARTWELL, GA 30643-1185
(757) 679-3392
Mailing address
466 N LEARD ST LOT 25, HARTWELL, GA 30643-1185
(757) 679-3392
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
0019015381
VA
225700000X
Massage Therapist
Primary
—
GA
Other
Enumeration date
06/21/2018
Last updated
11/22/2023
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