Provider Demographics
NPI:1932063138
Name:RELAX AND RELIEF THERAPEUTIC
Entity type:Organization
Organization Name:RELAX AND RELIEF THERAPEUTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEMETRICE
Authorized Official - Middle Name:LASHAY
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-216-9110
Mailing Address - Street 1:152 NEW ST STE 101C
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-7356
Mailing Address - Country:US
Mailing Address - Phone:478-216-9110
Mailing Address - Fax:478-216-9110
Practice Address - Street 1:152 NEW ST STE 101C
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-7356
Practice Address - Country:US
Practice Address - Phone:478-216-9110
Practice Address - Fax:478-219-7485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-11
Last Update Date:2025-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1023422433Other305R00000X