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NPI Code Detail

MEDICARE: JAMESON ROY

MEDICARE:   JAMESON  ROY
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 TherapistMT010747GA

General Provider Information

NPI Number : 1629437371
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMESON ROY
Provider Business Mailing Address
First Line : 3006 RIVER STATION DR
Second Line :
City : WOODSTOCK
State : GA
Zip : 30188-5901
Country : US
Telephone Number : 256-541-7086
Fax Number :
Provider Business Practice Location Address
First Line : 3006 RIVER STATION DR
Second Line :
City : WOODSTOCK
State : GA
Zip : 30188-5901
Country : US
Telephone Number : 256-541-7086
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2016
Last Update Date : 02/22/2016

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Directions to “ JAMESON ROY ” Practice Location

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