| NPI | 1972813046 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | ANGELA MARIE NICHOLS President 770-310-7701 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 225700000X Massage Therapist (Licence: GA MT002774) | 
| Enumeration Date | 2010-10-07 | 
| Last Update Date | 2010-10-07 |