Individual
ADELE MARIE NGO BANACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1755 N BROWN RD STE 200, LAWRENCEVILLE, GA 30043-2018
(678) 851-9972
Mailing address
1755 N BROWN RD STE 200, LAWRENCEVILLE, GA 30043-2018
(678) 851-9972
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT006744
GA
Other
Enumeration date
11/29/2021
Last updated
11/29/2021
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