Doctor Name: | PAULA CLANCY |
NPI Number: | 1982901344 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | MT002976 |
Business Practice Address: | 2140 Peachtree Rd Nw Suite 203 Atlanta, GA - 303091314 |
Business Phone Number: | 4043555499 |
Business Fax Number: | 4043555488 |
Mailing Address: | Po Box 1695, Po Box 1695 PINE LAKE |
State: | GA |
Postal Code: | 300721695 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 02/22/2011 |
NPI Last Update Date: | 02/22/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MT002976 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy 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. |