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Organization

LYMPHWORKS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SAMANTHA CANNON MARTIN MSOT/L, CLT, CLWT (OWNER)
(770) 310-8100
Entity
Organization

Contact information

Practice address
145 VICTOR DR, BUFORD, GA 30518-2563
(770) 310-8100
(833) 760-2107
Mailing address
145 VICTOR DR, BUFORD, GA 30518-2563
(770) 310-8100
(833) 760-2107

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
251E00000X
Home Health Agency
261QH0100X
Health Service Clinic/Center
332B00000X
Durable Medical Equipment & Medical Supplies

Other

Enumeration date
08/01/2022
Last updated
08/01/2022
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