Qiana L Gordon LMT

NPI 1770865420 - Massage Therapist - 225700000X

NPI Details
NPI 1770865420
Gender Female
Enumeration Date 09/19/2011
Last Updated 09/19/2011
Entity Type Individual
Active Over 6 years ago
Practice Location
4376 NORTHWIND DR
ELLENWOOD GA, 30294-2474, US
Phone (678) 886-2203
Fax
Business Location
4457 COVINGTON HWY
DECATUR GA, 30035-1214, US
Phone (678) 886-2203
Fax
Toxanomy
Taxonomy Code 225700000X
License State Georgia
License Number MT007007
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According to our database, Ms. Qiana L Gordon LMT NPI is 1770865420, taxonomy code is 225700000X and license number is MT007007, license state is located at Georgia. Qiana L Gordon LMT physically located at 4376 Northwind Dr, Ellenwood GA, 30294-2474. NPI Number Qiana L Gordon LMT has the Individual type.

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1770865420 NPI number is provided on an as is basis without warranty of any kind. 1770865420 is maintained by the National Plan & Provider Enumeration System. The contents of Qiana L Gordon LMT are for informational purposes only.