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MS. TAMI LYNN BACKSTROM L.M.T

>> Contractor >> Other Service Providers

Registrant NPI Number: 1902135205

Individual Registrant:
MS. TAMI LYNN BACKSTROM L.M.T
Gender: F
Sole Proprietor

Location and contact information for practice:
7193 DOUGLAS BLVD STE 103A  DOUGLASVILLE, GA 30135-1540 US
Tel: 770-845-4407  Fax: --

Contact information for business:
7193 DOUGLAS BLVD STE 103A  DOUGLASVILLE, GA 30135-1540 US
Tel: 770-845-4407  Fax: --

Registration Information:
NPI: 1902135205
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171W00000XOther Service Providers
Contractor
GAMT005428

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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