| NPI | 1023422433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMETRICE LASHAY HARRIS Licensed Massage Therapist 478-228-2823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: GA MT003571) |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2014-06-12 |