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General NPI Number Information
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NPI Number | 1760941975
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Entity Type | Individual
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Provider Name | DASHA A PRICE MASSAGE THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 03/18/2019
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Provider Practice Location Address
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Address Line | 2836 LAVISTA RD STE D
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City | DECATUR
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State | GA
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Zip | 30033-1301
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Country | US
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Telephone | 404-438-6154
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Fax |
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Provider Business Mailing Address
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Address Line | 8400 GLENWOODS TER
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City | RIVERDALE
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State | GA
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Zip | 30274-4313
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Country | US
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Telephone | 404-438-6154
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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 | MT006459
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License Number State | GA
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