| NPI | 1336592278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA JEROME ALLEN Organizer 770-905-0415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: GA MT006522) |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2016-07-15 |