Individual
MS. MICHELLE CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.T.
Contact information
Practice address
197 JEFFERSON PARKWAY, NEWNAN, GA 30263
(770) 683-9105
(770) 683-9107
Mailing address
197 JEFFERSON PARKWAY, NEWNAN, GA 30263
(770) 683-9105
(770) 683-9107
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT002959
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT002959
MASSAGE THERAPIST
GA
Enumeration date
09/26/2007
Last updated
09/26/2007
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