Organization
DIVINE HEALTH AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TABITHA MACON (OWNER)
(770) 356-9703
Entity
Organization
Contact information
Practice address
2045 DUTCHESS RD, LITHIA SPRINGS, GA 30122-2312
(770) 356-9703
Mailing address
2045 DUTCHESS RD, LITHIA SPRINGS, GA 30122-2312
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
02/11/2019
Last updated
06/18/2020
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