Provider Demographics
NPI:1669644647
Name:JAMES, PATRICIA ANNE (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANNE
Last Name:JAMES
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:91 BRIARWOOD CT
Mailing Address - Street 2:
Mailing Address - City:LENOX
Mailing Address - State:GA
Mailing Address - Zip Code:31637-3237
Mailing Address - Country:US
Mailing Address - Phone:229-848-1014
Mailing Address - Fax:229-387-8864
Practice Address - Street 1:343 MAIN ST S
Practice Address - Street 2:
Practice Address - City:TIFTON
Practice Address - State:GA
Practice Address - Zip Code:31794-4897
Practice Address - Country:US
Practice Address - Phone:229-848-1014
Practice Address - Fax:229-387-8864
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-30
Last Update Date:2008-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT003139225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist