Individual
COREY VANDER VEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
808 MOUNT GLEN LN, WOODSTOCK, GA 30188-3171
(404) 966-5453
Mailing address
808 MOUNT GLEN LN, WOODSTOCK, GA 30188-3171
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT000538
GA
Other
Enumeration date
02/23/2016
Last updated
02/23/2016
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