Individual
ELAINE PONDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2323 MAIN ST, SUITE A2, TUCKER, GA 30084-8522
(770) 695-0016
Mailing address
2323 MAIN ST, SUITE A2, TUCKER, GA 30084-8522
(770) 695-0016
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT009483
GA
Other
Enumeration date
05/26/2014
Last updated
05/26/2014
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