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Ms. Samantha Elizabeth Wilson, MASSAGETHERAPIST
Massage Therapist in Tucker, Georgia
NPI 1295170959

Samantha Elizabeth Wilson is a Massage Therapist based in Tucker, GA. Samantha Elizabeth Wilson practices in Tucker, GA and has the professional credentials of MASSAGETHERAPIST. The NPI Number for Samantha Elizabeth Wilson is 1295170959 and holds a License No. MT004816 (Georgia).

The current practice location address for Samantha Elizabeth Wilson is 2185 Northlake Pkwy Ste 100, Tucker, GA and can be reached out via phone at 770-493-6360 and via fax at 770-493-6350.

Location: 2185 Northlake Pkwy Ste 100, Tucker, GA, 30084-4100
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1295170959
Provider Name
Samantha Elizabeth Wilson
Credential
MASSAGETHERAPIST
Provider Entity Type
Individual
Gender
Female
Address
2185 Northlake Pkwy Ste 100, Tucker, GA, 30084-4100
Phone Number
770-493-6360
Fax Number
770-493-6350
Provider Enumeration Date
05/07/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
MT004816 01 GA STATE LICENSE NUMBER
institution
Provider Business Practice Location Address Details
Address
2185 Northlake Pkwy Ste 100
City
Tucker
State
Georgia
Zip
30084-4100
Phone Number
770-493-6360
Fax Number
770-493-6350
person
Provider Business Mailing Address Details
Address
2185 Northlake Pkwy Ste 100
City
Tucker
State
Georgia
Zip
30084-4100
Phone Number
770-493-6360
Fax Number
770-493-6350
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
MT004816 (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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