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General NPI Number Information
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NPI Number | 1588573620
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Entity Type | Individual
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Provider Name | SIERRA CHARMAINE LOFTON
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Gender | Female
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Dates
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Enumeration Date | 09/03/2026
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Last Update Date | 09/03/2026
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Provider Practice Location Address
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Address Line | 1820 NOAHS ARK RD STE 104
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City | JONESBORO
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State | GA
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Zip | 30236-7455
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Country | US
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Telephone | 470-905-3193
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Fax |
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Provider Business Mailing Address
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Address Line | 3384 MOUNT ZION RD APT 8104
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-7885
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Country | US
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Telephone | 470-905-3193
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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 | MT012520
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License Number State | GA
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