Individual
GLENDA IVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
299 COOPER RD STE B, LOGANVILLE, GA 30052-2579
(706) 250-1769
Mailing address
2181 VALLEY CREEK CIR, SNELLVILLE, GA 30078-2530
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT005444
GA
Other
Enumeration date
06/11/2022
Last updated
06/11/2022
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