Individual
CANDICE RENEE GAULTNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
102 W 2ND ST, MANCHESTER, GA 31816
(706) 846-8337
Mailing address
102 W 2ND ST, MANCHESTER, GA 31816-1647
(706) 846-8337
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT006116
GA
Other
Enumeration date
07/09/2014
Last updated
07/09/2014
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