| Organization Name: | MICHELLE WATERS THERAPY INC |
| NPI Number: | 1881937878 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHELLE WATERS (OWNER) |
| Mailing Address: | 155 1st Ave Cochran |
| State: | GA US |
| Postal Code: | 310145740 |
| Phone Number: | 4789543711 |
| Fax Number: | 4789543711 |
| NPI Enumeration Date: | 03/28/2013 |
| NPI Last Update Date: | 03/28/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QX0100X |
| License Number: | OT000395 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Occupational Medicine |
| Taxonomy Definition: | |