Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
May 7, 2026
License(s)
PT017609 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 4161 SPRING VALLEY CIR | Tucker, GA 30084-1106 | |
| LOCATION | 4161 SPRING VALLEY CIR | Tucker, GA 30084-1106 | 770-906-1026 |
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