MRS. HOLLY DEEN DEROSSETT L.M.T.
NPI 1225463482
Massage Therapist in Valdosta, GA
Active since September 06, 2013
About Mrs. Holly Deen Derossett L.m.t. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. HOLLY DEEN DEROSSETT L.M.T. (NPI 1225463482) is an individual massage therapist in Valdosta, Georgia, licensed in Georgia (MT005886) and active in the NPI registry since September 2013.
NPPES Registry Identity
NPI1225463482
Entity TypeIndividualFemale
Primary Taxonomy225700000X
Provider Legal NameMRS. HOLLY DEEN DEROSSETTCredential: L.M.T.
Location Address2420 BEMISS RD., SUITE BValdosta, GA 31602
Mailing Address2420 Bemiss Rd., Suite BValdosta, GA 31602 · (229) 293-9511 · Fax (229) 293-9141
Phone(229) 293-9511
Sole ProprietorNo
Enumeration DateSeptember 6, 2013
✔ NPI 1225463482 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
License✔ Licensed in GA · MT005886
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.
2420 BEMISS RD., Valdosta, GA 31602
Other Names 1
Former Name (1)Ms. Holly Rebecca Deen L.m.t.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1225463482, enumerated as an "individual" on September 06, 2013.
The provider is located at 2420 BEMISS RD. SUITE B VALDOSTA, GA 31602 and the phone number is (229) 293-9511.
Massage Therapist with taxonomy code 225700000X.
