Organization
DOUGLASVILLE THERAPEUTIC MASSAGE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY LOU ROSS LMT (PRESIDENT)
(404) 402-9985
Entity
Organization
Contact information
Practice address
4147 N QUAIL DR, DOUGLASVILLE, GA 30135-3844
(404) 402-9985
(770) 489-6961
Mailing address
4147 N QUAIL DR, DOUGLASVILLE, GA 30135-3844
(404) 402-9985
(770) 489-6961
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT000186
GA
Other
Enumeration date
04/12/2007
Last updated
08/22/2020
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