Provider Demographics
NPI:1659627933
Name:DUGGER, PATSY ANN (LMT)
Entity type:Individual
Prefix:MRS
First Name:PATSY
Middle Name:ANN
Last Name:DUGGER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5920 IRONSTONE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-5705
Mailing Address - Country:US
Mailing Address - Phone:706-221-7849
Mailing Address - Fax:
Practice Address - Street 1:3228 UNIVERSITY AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-7209
Practice Address - Country:US
Practice Address - Phone:706-563-2229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT005661225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist