Seretta Arstacia Crutcher, MT

Individual provider Active NPI Massage Therapist · Lithia Springs, GA

NPI 1902045909 · NPPES record last updated Feb 13, 2009

Key facts

NPI
1902045909
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MT004500 (GA)
Practice address
870 Crestmark Dr
Suite 103
Lithia Springs, GA 30122-2665
Phone
(404) 428-9043
NPI assigned
Feb 13, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Medical Technician

State licenses

LicenseStateTypeSpecialty
MT004500GAMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT004500 GA Yes

Addresses

Primary practice location

870 Crestmark Dr
Suite 103
Lithia Springs, GA 30122-2665

Mailing address

PO Box 5133
Douglasville, GA 30154-0003
Phone (404) 428-9043

Other providers in Lithia Springs, GA

All providers in Lithia Springs, GA · Massage Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.