Registry details
Type
Individual
Primary specialty
Physical Therapist, Neurology
Enumerated
Sep 17, 2018
License(s)
PT013450 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 12 EXECUTIVE PARK DR NE | Atlanta, GA 30329-2206 | 404-778-7777 |
| MAILING | 526 MARSH TRAIL CIR APT 526 | Atlanta, GA 30328-5791 | 404-431-6655 |
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