Provider Demographics
NPI:1093002594
Name:CURINGTON, WILMA JEAN (MT)
Entity Type:Individual
Prefix:MS
First Name:WILMA
Middle Name:JEAN
Last Name:CURINGTON
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4115 WILL LEE RD
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-1951
Mailing Address - Country:US
Mailing Address - Phone:404-805-4185
Mailing Address - Fax:
Practice Address - Street 1:4115 WILL LEE RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-1951
Practice Address - Country:US
Practice Address - Phone:404-805-4185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT001776225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist