Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Apr 17, 2015
License(s)
PT005949 (GA), 5949 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 6397 LEE HWY | Chattanooga, TN 37421-2564 | |
| LOCATION | 12990 HIGHWAY 9 N STE 110 | Milton, GA 30004-4196 | 770-751-0095 |
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