Registry details
Type
Individual
Primary specialty
Physical Therapist, Orthopedic
Enumerated
Aug 28, 2025
License(s)
PT017895 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 5265 STONE CROFT TRL SW | Atlanta, GA 30331-7697 | 404-731-1731 |
| LOCATION | 560 GRADY AVE STE C | Fayetteville, GA 30214-1975 | 770-461-6488 |
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