Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Nov 9, 2006
License(s)
pt008528 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 3604 VERANDAH DR STE AANDB | Augusta, GA 30909-5608 | 706-414-0991 |
| MAILING | 5215 TEAL LN | Evans, GA 30809-0699 | 706-414-0991 |
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