Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Aug 27, 2014
License(s)
070021005 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 1061 HARMON AVE | Fort Stewart, GA 31314-5641 | 912-435-6965 |
| LOCATION | 1061 HARMON AVE | Fort Stewart, GA 31314-5641 | 912-435-6965 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.