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Individual

MRS. CLARICE M EZEANYA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
302 SATELLITE BLVD NE STE 111, SUWANEE, GA 30024-7182
(862) 202-6596
Mailing address
1717 BAKERS MILL RD, DACULA, GA 30019-2958
(862) 202-6596

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
40QA01471200
NJ
225100000X
Physical Therapist
Primary
PT011257
GA

Other

Enumeration date
12/27/2012
Last updated
11/24/2021
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