Individual
NICOLE DILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
6252 CENTURY PARK PL SE, MABLETON, GA 30126-7700
(470) 429-7867
Mailing address
6252 CENTURY PARK PL SE, MABLETON, GA 30126-7700
(470) 429-7867
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT011399
GA
Other
Enumeration date
07/12/2021
Last updated
07/12/2021
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