Individual
MS. CARYL SUE FASNACHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2685 LOGAN WAY, LAWRENCEVILLE, GA 30043-6111
(678) 216-9299
Mailing address
2685 LOGAN WAY, LAWRENCEVILLE, GA 30043-6111
(678) 216-9299
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT009416
GA
Other
Enumeration date
01/27/2014
Last updated
01/27/2014
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