Individual provider · Type 1 NPI
Qiana L. Gordon, LMT
Massage Therapist · Ellenwood, GA
NPI number
1770865420
Active
Practice location
4376 Northwind Dr
Ellenwood, GA 30294-2474
Mailing address
4457 Covington Hwy
Decatur, GA 30035-1214
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist Primary | 225700000X | MT007007 (GA) |
Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
Other massage therapist providers in Ellenwood
About NPI 1770865420
Qiana L. Gordon, LMT's National Provider Identifier is 1770865420, issued on Sep 19, 2011. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Ellenwood, GA. The record was last updated on Sep 19, 2011.