NPI 1427320522

Larry Jason Reagor, LMT

Practitioner Massage Therapist Newnan, GA

Practice location

Address: 29 Vista Bella Way, Newnan, GA 30265-6014
Phone: (770) 584-0003

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence MT006894 (GA)

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Registry record

NPI: 1427320522
Entity type: Individual
Sex (as registered): Male
NPI issued: 4 Feb 2012
Record last updated: 20 Oct 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.