Individual provider · NPI-1

Carolyn T Davis, LMT NCTMB SET

Massage Therapist · Lawrenceville, GA

NPI number1972826899
StatusActive
Last updated in NPPESMar 1, 2011

Details

NPI
1972826899
Entity type
Individual (NPI-1)
Name
Carolyn T Davis
Credential
LMT NCTMB SET
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 5, 2010
Last updated
Mar 1, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225700000X Massage TherapistMT001114GAYes

Practice location

1130 Hurricane Shoals Rd Ne
Suite 1900
Lawrenceville, GA 30043-4851

Phone 678-462-2972

Mailing address

582 Mackenzie Ct
Dacula, GA 30019-2385

Phone 678-462-2972

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