Organization
MODERN MEDICAL MASSAGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AIMEE S JONGEJAN (BUSINESS MANAGER)
(912) 577-3991
Entity
Organization
Contact information
Practice address
664 SCRANTON RD, BRUNSWICK, GA 31520-1945
(912) 577-3991
Mailing address
211 WELLINGTON PL, BRUNSWICK, GA 31523-7067
(912) 577-3991
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MT002240
GA
Other
Enumeration date
02/22/2010
Last updated
02/22/2010
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