NPI 1518217405

Janine Celia Willey, LMTCNMT

Practitioner Mechanotherapist Douglasville, GA

Practice location

Address: 2080 Fairburn Rd Suite G, Douglasville, GA 30135-1064
Phone: (678) 213-4266
Mailing address: 204 Lost Lake Way, Villa Rica, GA 30180-4864

Registered specialties (2)

Mechanotherapist Primary

Other Service Providers Taxonomy 172M00000X Licence MT006850 (GA)

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Contractor

Other Service Providers Taxonomy 171W00000X Licence MT006850 (GA)

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Registry record

NPI: 1518217405
Entity type: Individual
Sex (as registered): Female
NPI issued: 18 Sep 2012
Record last updated: 18 Sep 2012

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.