Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
May 1, 2019
License(s)
PT016982 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 2510 GA HIGHWAY 127 | Kathleen, GA 31047-2828 | 478-971-1153 |
| MAILING | 3708 NORTHSIDE DR | Macon, GA 31210-2404 | 478-745-4206 |
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