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NPI Code Detail

MEDICARE: JACQUELINE POWELL

MEDICARE:   JACQUELINE  POWELL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistMT000874GA

General Provider Information

NPI Number : 1033921416
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE POWELL
Provider Business Mailing Address
First Line : 4404 NORTHLAKE HEIGHTS CIR NE
Second Line :
City : ATLANTA
State : GA
Zip : 30345-2251
Country : US
Telephone Number : 770-744-8052
Fax Number :
Provider Business Practice Location Address
First Line : 6255 BARFIELD RD
Second Line :
City : ATLANTA
State : GA
Zip : 30328-4319
Country : US
Telephone Number : 404-920-8492
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2025
Last Update Date : 01/23/2025

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Directions to “ JACQUELINE POWELL ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.