Individual
AMBER VANDIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
541 HISTORIC HWY N, DEMOREST, GA 30535
(706) 754-3113
Mailing address
PO BOX 37, DEMOREST, GA 30535-0037
(706) 754-3113
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT005331
GA
Other
Enumeration date
11/16/2011
Last updated
11/16/2011
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