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General NPI Number Information
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NPI Number | 1558195057
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Entity Type | Individual
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Provider Name | TARAMETHIA MORELAND LMT
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Gender | Female
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Dates
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Enumeration Date | 08/27/2024
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 1435 N EXPRESSWAY STE 103
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City | GRIFFIN
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State | GA
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Zip | 30223-1700
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Country | US
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Telephone | 770-584-2537
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Fax |
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Provider Business Mailing Address
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Address Line | 101 BELGIAN CT
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City | HAMPTON
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State | GA
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Zip | 30228-3524
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Country | US
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Telephone | 470-502-3764
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT014864
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 172M00000X
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Taxonomy Name | Mechanotherapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 173C00000X
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Taxonomy Name | Reflexologist
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License Number |
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License Number State |
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