Individual provider · NPI-1

Caryl Sue Fasnacht, LMT

Massage Therapist · Lawrenceville, GA

NPI number1891118816
StatusActive
Last updated in NPPESJan 27, 2014

Details

NPI
1891118816
Entity type
Individual (NPI-1)
Name
Ms. Caryl Sue Fasnacht
Credential
LMT
Sex
Female
Sole proprietor
Yes
Enumeration date
Jan 27, 2014
Last updated
Jan 27, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225700000X Massage TherapistMT009416GAYes

Practice location

2685 Logan Way
Lawrenceville, GA 30043-6111

Phone 678-216-9299

Mailing address

2685 Logan Way
Lawrenceville, GA 30043-6111

Phone 678-216-9299

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