Individual
MR. CHARLES LEROY WATERS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1 SHERWOOD DR, HINESVILLE, GA 31313-2813
(912) 332-5965
Mailing address
1 SHERWOOD DR, HINESVILLE, GA 31313-2813
(912) 332-5965
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT009572
GA
Other
Enumeration date
02/07/2023
Last updated
07/07/2023
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