Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Aug 6, 2020
License(s)
PT014647 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 2089 TERON TRCE STE 120 | Dacula, GA 30019-1609 | 770-904-2357 |
| MAILING | 2089 TERON TRCE STE 120 | Dacula, GA 30019-1609 | 770-904-6009 |
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