Provider Demographics
NPI:1245999861
Name:ARMSTRONG, JAMAL (LMT)
Entity type:Individual
Prefix:
First Name:JAMAL
Middle Name:
Last Name:ARMSTRONG
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8913 TEAL LN
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-5059
Mailing Address - Country:US
Mailing Address - Phone:954-604-8422
Mailing Address - Fax:
Practice Address - Street 1:8913 TEAL LN
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-5059
Practice Address - Country:US
Practice Address - Phone:954-604-8422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-10
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT012614225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty