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Michael Ananta Rosidivito, LMT
Massage Therapist in Smyrna, Georgia
NPI 1114661402

Michael Ananta Rosidivito is a Massage Therapist based in Smyrna, GA. Michael Ananta Rosidivito practices in Smyrna, GA and has the professional credentials of LMT. The NPI Number for Michael Ananta Rosidivito is 1114661402 and holds a License No. MT011960 (Georgia).

The current practice location address for Michael Ananta Rosidivito is 2200 Atlanta Rd Se Apt I3, Smyrna, GA and can be reached out via phone at 609-314-1254. You can also correspond with Michael Ananta Rosidivito through the mailing address at 2200 ATLANTA RD SE APT I3, SMYRNA, GA - 30080-1538 (mailing address contact number: 160-931-4125).

Location: 2200 Atlanta Rd Se Apt I3, Smyrna, GA, 30080-1538
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1114661402
Provider Name
Michael Ananta Rosidivito
Credential
LMT
Provider Entity Type
Individual
Gender
Male
Address
2200 Atlanta Rd Se Apt I3, Smyrna, GA, 30080-1538
Phone Number
609-314-1254
Fax Number
Provider Enumeration Date
04/24/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2200 Atlanta Rd Se Apt I3
City
Smyrna
State
Georgia
Zip
30080-1538
Phone Number
609-314-1254
Fax Number
person
Provider Business Mailing Address Details
Address
2200 Atlanta Rd Se Apt I3
City
Smyrna
State
Georgia
Zip
30080-1538
Phone Number
160-931-4125
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
MT011960 (Georgia)
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
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