Suzan Abdushukur – Massage Therapist

Key facts

NPI: 1619697489
Entity type: Individual (NPI type 1)
Primary specialty: Massage Therapist 225700000X
License: MT012194 (GA)
Practice address: 299 Cooper Rd Ste B
Loganville, GA 30052-2579
Phone: (706) 250-1769
NPI assigned: Aug 31, 2022
Sex: Female
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Aos Healing Center, LLC Health Service Clinic/Center · Loganville, GA · NPI 1467102988

NPD MASSAGE THERAPIST

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
MT012194	GA	MD	Massage Therapist

Practice roles

Organization	Specialty	Status	New patients
Aos Healing Center, LLC	Massage Therapist	Current since Jul 14, 2024	Accepting new patients

Locations

299 Cooper Rd
Ste B
Loganville, GA 30052
Phone (706) 250-1769

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Massage Therapist	225700000X	MT012194	GA	Yes

Addresses

Primary practice location

299 Cooper Rd Ste B
Loganville, GA 30052-2579

Mailing address

3853 Moos Creek Walk
Loganville, GA 30052-8420
Phone (404) 789-6720

Other providers in Loganville, GA

All providers in Loganville, GA · Massage Therapist in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.